Nurses' evaluation of a new four-layer bandage system

This small study was undertaken to evaluate a new four-layer bandage (4LB) system (Ultra Four, Robinson). The aim was to provide initial user information about the product and compare it with the previously used original Charing Cross 4LB system. Subjective evaluations of the comparative performance of the Ultra Four system were assessed using a weekly treatment questionnaire in 30 patients. Both patients and nurses commented on the usability of each individual layer and the overall performance of the new system over a period of up to 12 weeks or until healing. After 12 weeks 15/30 ulcers (50%) had healed. Using life table analysis, allowing for patients who failed to reach 12 weeks, the expected healing rate was 65%. The performance of each individual layer was considered similar to those of the Charing Cross 4LB in terms of wear and tear, slippage and ease of removal. However, there was an indication that the fourth layer provided superior wear and tear at the heel and better ease of application and ease of removal than the original. After one week of treatment the Ultra Four system was rated better than the original 4LB for wear and tear at the heel in 15/28 patients (54%), for overall wear and tear in 12/25 (48%), for ease of application in 9/27 (33%) and for ease of removal in 11/26 (42%). This study relied on the nurses' experience rather than a direct comparison between bandages. However, it does indicate that the relative performance of products may help nurses to make decisions when objective comparative data are not available.