Impact of Compression... Beyond the swollen leg

Suzie Ehmann, PT DPT CWS CLT-LANA, Edema Management, Carolinas Heatlhcare System Stanly, Albemarle, NC and Marta Ostler, PT CWS CLT, Northeast Wyoming Wound Clinic, Sheridan Memorial Hospital, Sheridan, WY
Purpose:  Compression applied to the limb is the standard of care for the management of venous leg ulcers (VLU)1.  Mechanism of the impact of compression on healing VLU has focused primarily on the impact that compression has on the underlying venous anatomy.2   A new type of compression therapy, characterized as 'fuzzy wale' compression, that when applied directly in contact with the wound bed, has shown dramatic impact on healing times in previously recalcitrant wounds.  5 detailed case studies to be presented demonstrating outcomes including change in wound size and time to wound closure.

Methods: 5 patients between the ages of 64 -91,  (1men, 4women) presented to separate outpatient  wound/lymhedema clinics with non-healing ulcerations of varying durations (6months to 19yrs).  All patients received 'fuzzy wale compression' directly in contact with the wound bed along with various secondary dressing to maintain a moist wound environment.  Additional compression therapy applied over the 'fuzzy wale compression as consistent with past plan of care.  Wound measurements and photos to be provided.

Findings:  In each case, noted improvement in wound size and appearance with each dressing change.  Previously recalcitrant wounds were resolved with only the addition of the 'fuzzy wale' compression directly on the wound bed.  It was noted that re- epithelization was observed along the "furrows" created by the fuzzy wale compression.

Conclusions:  Compression applied to the leg has been shown to have positive impact on venous circulation,  however, little has been mentioned in the literature about the impact of compression applied directly to the wound base. The ability of the fuzzy wale technology to apply compression in various patterns directly to the wound bed  and along wound margins shows improvements in wound healing and ultimately wound closure.  Resolution of induration and fibrosis in the peri-wound tissue, as well as epithelial migration are evidence of increased perfusion promoting wound healing.