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Nursing Best Practice Guideline
External compression using various forms of pneumatic compression pumps (PCPs) are
indicated for individuals with chronic venous insufficiency. However, there is no strong evidence
about the effects of intermittent pneumatic compression (IPC) on venous leg ulcer. In the
review by Mani, Vowden and Nelson (2003), they found that there is conflicting evidence
whether or not IPC can help heal venous leg ulcers.
Note: At time of publishing, this recommendation is not inclusive of elastic and non-elastic
bandages (RNAO Consensus Panel, 2004).
Findings from several studies indicate that high compression bandaging should be used for
venous leg ulceration, as per La Place’s Law (NZGG, 1999):
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La Place’s Law:
The theoretical pressure produced beneath a bandage can be calculated as follows:
P = 4630 x N x T
C x W
Where
P = sub-bandage pressure (mmHg)
N = number of layers
T = tension within bandage (Kgforce)
C = limb circumference (cm)
W = width of bandage (cm)
It can be seen that sub-bandage pressure is directly proportional to the tension in the bandage
during application and the number of layers applied, but inversely proportional to the radius
of curvature of the limb (Logan, Thomas, Harding & Collyer, 1992).
The treatment of venous stasis disease demands the life-long use of therapeutic compression.
The concepts, practice, and hazards of graduated compression should be fully understood by
those prescribing and fitting (SIGN, 1998). Graduated compression hosiery should be prescribed
for life (CREST, 1998a).
Provided the client has been measured by a certified stocking fitter for the correct size, elasticized
stockings are a safe alternative to bandages. They can be full-length, but generally