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CLINICAL PROBLEM & PAST MANAGEMENT
Four-layer compression bandaging has been used as the foundation treatment for chronic venous insufficiency and leg ulcers in local hospitals. However, many patients in our humid tropical country are unable to tolerate this treatment, often reporting skin irritation, itch, odour, pain and discomfort. Further compounding to these is the high cost of treatment and inconvenience to travel to hospitals, resulting in poor compliance to treatment. As an alternative, a modified flexible compression was designed for this group of patients.
CURRENT APPROACH
The flexible compression therapy aims to promote healing at patients' level of comfort, convenience and affordability. This therapy uses a soft tubular net as a primary protective layer, an elastomer crepe bandage as second layer for light compression, and lastly an elastic tubular support to hold the crepe bandage in position as well as exert compression pressure. The therapy is customised to the individual; patient may have all the three layers or two layers applied depending on their comfort level.
Patients and their caregivers were given a short overview of their disease process and the techniques of application and removal of tubular layer should they experience any discomfort. This helped to increase their awareness, provide flexibility in usage and correspondingly, increased compliance to treatment.
FINDINGS
The modified flexible compression was done on twenty male and female patients with a mean age of 65 years and a history of chronic venous ulcers and lymphoedema between 1 month and 30 years. Compliance rate to therapy was 95%. All patients showed improvement with 85% attaining complete healing within 3 months.
CONCLUSION
In our study, flexible compression therapy used for venous ulcers and lymphoedema in patients living in humid tropical conditions received better compliance and proved an effective alternative in its treatment.