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6 JCN
Supplement 2016
Compression therapy has long been
accepted as the most effective way
to reduce venous hypertension
and aid healing of venous leg
ulceration. This began with the
work of Professor Moffatt and a
clinical group at Charing Cross
Hospital, who developed the first
compression bandaging system
in 1992 (Mears and Moffatt, 2002;
Moffatt, 2004).
Innovative compression therapy
systems can improve practice
Since 1992 other bandaging
systems have been devised and
there are now multiple compression
therapy choices available to achieve
40mmHg at the ankle and 20mmHg
below the knee to activate effective
venous return. But, how can we most
effectively, consistently and safely
accomplish this?
The early work of Professor
Moffatt constituted a four-layer
bandaging system that led on to the
development of four-layer systems.
Safe application of these bandages
posed challenges as they needed to be
applied with skill and consistency to
ensure that they were put on with the
same bandage tension from ankle to
below the knee, and with an accurate
50% overlap to achieve the correct
sub-bandage pressure. The risk of
inaccurate bandage application,
which may be due to knowledge
or skill, can result in variable sub-
bandage pressures, potentially leading
to either pressure damage to the
lower limb if too tight, or ineffective
venous return if too loose. Therefore,
patients may not receive the full
benefit of the treatment (Wounds
International, 2013).
Treating leg ulcers makes up a large part of a nurse’s caseload. While compression therapy
with graduated multilayer bandaging has been widely accepted as recommended treatment,
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in its application. Thus, it is important that clinicians keep up to date with new methods of
compression that can promote concordance, improve healing rates and achieve cost savings —
all vital elements in leg ulcer management. juxtacures
™
(medi UK), an adjustable compression
system, is one such innovation that helps to alleviate some of the challenges associated with
multilayer bandaging.
This feature asks experts in their particular field to take a look at a therapy area and
examine some of the challenges that general practice nurses (GPNs) may face. Here, we
look at how...
From the patient’s perspective,
the layered bandaging systems have
an impact on quality of life, as they
can be bulky and hot and result
in problems such as odour and
difficulty in putting on shoes, thus
making patients reluctant to concord
(Lay-Flurrie, 2005; Wicks, 2015).
Two-layer bandaging systems
were introduced to address the
issues of safety and to reduce the
risk of incorrect sub-bandage
pressures, while offering effective
healing rates (Benigni et al, 2007).
However, these bandage systems,
although less bulky, still created
similar challenges for patients as
with the four-layer systems.
However, there is now an
innovative compression garment
called juxtacures
™
(medi UK), which
offers an effective alternative to
traditional compression bandaging.
WHAT IS JUXTACURES?
This innovative, instantly adjustable
system is applied to the lower limb,
from the ankle to below the knee, and
can be easily adjusted to deliver the
THE ANSWER
Gill Wicks, consultant nurse and tissue
viability lead, Great Western Hospitals
NHS Foundation Trust
THE PROBLEM
Ask the expert