Effect Of Four-Layer Dressing On Venous Ulcer

BACKGROUND: Venous ulcer is a chronic disease and has periods of exacerbation and remission. It takes a long time to heal, resulting in physical and psychological discomfort thereby negatively affecting the functional status of the patients. Various bandage systems, single layered, double layered and multiple layered with elastic and non elastic components have been commercialized. A requirement of sustained pressure brought the four-layer bandage into picture. We tried to study the bacteriology of the venous ulcers and the effect of our layer bandage on the healing of the ulcer.METHODS: Sixty patients were recruited for the study. However, 4 patients had a bilateral disease and so a total of 64 limbs were taken into consideration in the study. Clinical details of all patients with wound size measurement by gauze piece, wax paper and scale was done. The wounds were initially debrided and photographic records of all patients was maintained. Patients were followed up every week and the dressing was changed every week.RESULTS: 93.8% had complete healing while 1.6% had partial healed ulcer and 4.7% had non healing ulcer. After excluding the four ulcers that did not heal, 16.6% had recurrence while 50 out 60 had no recurrence in the follow-up for one year. There was a significant correlation (P<0.001) between ulcer size and the number of dressings.CONCLUSIONS: Compression therapy is the mainstay of treatment of venous ulcer. Compression in the range of 30 mmHg to 40 mmHg is the most effective level for uncomplicated venous ulcers with adequate arterial competency.