Page 175 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

150 Chapter 6. Treatment

compression, and multicomponent bandages appearing to
be more effective than single layered bandages (O’Meara
et al. 2009 ). However, in 60–70 % of cases, ulcers recur with
those that do heal requiring a lifelong plan to prevent recur-
rence, usually consisting of the on-going use of compression
bandages, which imposes a life-long chronic treatment on the
individual (Abbade et al. 2005 ). Moffatt et al. ( 2009 ) identi-
fied that recurrence rates of wounds were 2–20 times greater
when patients did not correctly comply with their prescribed
compression bandages suggesting that compliance to treat-
ment is vital for the complete healing of wounds.
Although compression bandages are considered to be the
gold standard treatment for venous leg ulcers concordance
of them by patients can be poor, which has been noted to be
between 48 and 83 % (Moffatt 2004b ; Jull et al. 2004a ; Van
Hecke et al. 2007 ). Although compression bandages may be
considered the cornerstone of venous leg ulcer treatment,
this is only if they are fitted correctly and used appropriately.
Unfortunately, this is not always the case (Feben 2003 ; Filed
2004 ; Todd 2011 ). This is important as correct application
can lead to faster healing times, reduced nursing time and
improved patient concordance with treatment (Todd 2011 ).
Indeed, the healing of leg ulcers is largely dependent on the
consistency and accuracy of the bandaging technique (Todd
2011 ). It has been suggested that the right bandaging tech-
nique is achieved with experience (Hopkins 2008 ), however,
as Satpathy et al. ( 2006 ) identified in their study the correct
pressure is often not always achieved even by experienced
practitioners. Furthermore, studies have reported that nurses
who claim to have experience in applying compression
bandages often bandaged in a way that did not produce sus-
tained graduated compression (Feben 2003 ). Consequently,
although there may be a link between experience and accu-
rate technique this is neither linear nor straight-forward. The
inaccurate bandaging could lead to delayed healing times,
problems relating to ill-fitted bandages and reduced patient
concordance with treatment. Furthermore, if the compression
is incorrect then there could be poor clinical outcomes for the