Compression strapping: the development of a novel compression technique to enhance compression therapy and healing for 'hard-to-heal' leg ulcers.

Non healing wounds of the lower limb continue to be a significant issue for both practitioners and patients. Failure of gold-standard management demands a creative response. This article describes the development of a novel and intuitive strapping technique overlying the compression bandage that appears to have an influence in healing complex lower limb ulcers. A retrospective audit of 17 patients with 25 ulcers allows further analysis and discussion. The strapping technique uses cohesive inelastic compression bandaging; narrow strips of bandages are layered in a fan distribution over the ulcer and oedema. This approach seems to offer an intuitive response to these complex wounds, allowing management to be tailored to the site of the ulcer and oedema. Tolerance for this less bulky compression therapy regime is excellent, thereby aiding healing and reducing all costs associated with non healing leg ulcers.

The importance and function of footwear in managing lymphoedema.

Lymphoedema is a chronic progressive condition of the lymphatic system. It occurs because of poor lymphatic drainage of an area of the body leading to an increase in interstitial volume secondary to a build up of lymphatic fluid, and chronic oedema (Lymphoedema Framework, 2006; Tiwari A, et al 2003). Lymphoedema may affect any part of the body but the arms and legs are the most common sites. It is estimated that there are at least 100?000 sufferers in the UK alone (Moffat C et al, 2003). This article seeks to look at the importance of appropriate footwear in patients with chronic swelling caused by lymphoedema and takes a look at some of the practical problems encountered with footwear in clinical practice.