Bandaging in the treatment of venous ulcers: a European view

The principal treatment of venous ulcers in ambulatory patients in bandaging. The physiological rationale for this treatment is to improve the venous hemodynamic abnormality caused by prolonged venous hypertension due to limb venous valvular incompetency. Correct bandaging results in the reduction of limb edema and ulcer healing. A number of different bandages and combined bandaging regimens are used in the treatment of venous ulceration. Recently the European Tissue Repair Society has defined different types of bandages based on their function into four groups: (1) Extensible bandage; (2) Elastic bandage; (3) Compression bandage; and (4) Support bandage. The ability of a bandage to produce a gradient compression starting at 35 to 45 mmHG at the ankle and reducing as the bandage approaches the knee is stated in the literature as a goal of bandaging. Our studies and others have shown that routine measurements of limb circumference as an indicator of edema reduction is another way of monitoring the efficacy of the results of bandaging since edema reduction and control is associated with improved ulcer healing.