Practical Issues in Wound, Skin and Ostomy Management
Very well written. I got alot out of this.
with an ABI of 1.07 is high compression ok?
Overall, this was a well written article.
I have some concerns with your statement “High compression levels should be used only if the patient’s ABI ranges from 0.6 to 1.0.”
Full (High) therapeutic compression, applying less than or equal to 40 mmHg of compression at the ankle, is indicated for patients who are not in CHF and their ABI is greater than or equal to 0.9.
“Modified” not “High” compression therapy is indicated for patients not in CHF and their ABI runs between 0.6 and 0.8.
Any patient’s ABI equal to or less than 0.5, the clinician should not apply any compression to the extremity out of concerns of ischemia (necrosis) and should refer them to a Vascular Service since at this level, 50% or less of the blood flow going to the arm is going to the foot.
One should also be concern about the diabetic patient whose ABI is 1.3 or greater since this might represent calcified arteries with abnormally elevated ABI levels and the ABI should not be used for criteria for applying compression therapy.
Don Wollheim, MD
What is a “3 layer wrap” for stacis wound care?
It is a 3 layer compression wrap.
It’s a 4 layer wrap (Ex.,Profore) minus the 3rd layer (this is the long stretch layer that provides the majority of the pressure). Known as “Modified compression” used if the ABI is between 0.6 and 0.8.
I had 3 serious, extremely painful ulcers, one on the ankle of my right leg, one on the ankle of my left leg and one on the heel of my left leg. The one on the ankle of my left leg was almost 3 years old. A podiatrist judged that they were venous ulcers and sent me to a vascular specialist who after examination claimed that I had no vascular problems. After roughly 3 months of “care” and virtually no healing results and being told by my care-taker that his treatment (compression wraps , etc.) might take about a year and also being told that he was concerned about the possibility of amputation, I stopped going to the podiatrist about the same time my wife was at a feed store getting some stuff for our animals and noticed a tube of EMT GEL, a wound care for large and small animals. She purchased a tube and I have been using it for about 3 months and at this time all of my wounds have healed.
March 13, 2016
Very informative I have venous ulcers for over 25years an it’s been a struggle I’ve yet everything to help cure or limit the conditions.I had 3 stents in my pelvic,8 leg ablation,skin grafts an now I’m trying a wound-vac looking for closer.my question is if this should help with closer should this keep the wound closed with compression
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