Compression therapy is used for persistent chronic oedema and venous ulceration. Compression makes the venous valves more competent, by reducing the reflux of blood in the veins of the legs. Compression bandages are either short or long stretch. Short stretch bandages are used for those patients that are active. Long stretch bandages are used for those that are less ambulatory. The application of compression bandages ensures the pressures created are graduated along the leg, with the highest pressures being above the ankle and slowly decreasing up the leg.
The application of compression bandage should extend from the toes to just below the knee. They are applied either in a spiral or herringbone ‘figure eight’ pattern, but they should all be applied with a 50% overlap.
Compression therapy should only be applied by a trained practitioner and only on patients where an ankle brachial index measure (ABI) has been carried out which has excluded arterial disease.
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8.6 Treatment of wounds in diabetic patients
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Why are diabetic patients more prone to foot ulcers?
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Diabetic patients are more susceptible to infections due to fluctuating blood sugar and often have a weakened immune system. They have low sensitivity due to neuropathy, which diminishes the feeling of pressure, pain and temperature. Because of this, they do not react to the relief of pressure because they do not feel pain, heat or discomfort like other people.
Motor neuropathy leads to muscle weakness and atrophy in the small muscles of the foot. This produces deformed feet, a finer fat layer over bony protuberances and increased pressure on sensitive areas. Hyperkeratosis is formed in the areas exposed to pressure and, simultaneously, the pressure also increases in the deeper layers of tissue. The patient usually does not see these changes due to diminished sensitivity.
Foot ulcers are one of several complications that diabetes patients experience and, as nurses, are important to prevent. We can help by regular inspection of the feet if the patient has impaired sensation in the extremities. The most important preventive measure is to check inside the patients shoes every day to see if there are any foreign objects inside the shoe, since they will not be able to feel this themselves.
Incorrect
All three options are correct!
Diabetic patients are more susceptible to infections due to fluctuating blood sugar and often have a weakened immune system. They have low sensitivity due to neuropathy, which diminishes the feeling of pressure, pain and temperature. Because of this, they do not react to the relief of pressure because they do not feel pain, heat or discomfort like other people.
Motor neuropathy leads to muscle weakness and atrophy in the small muscles of the foot. This produces deformed feet, a finer fat layer over bony protuberances and increased pressure on sensitive areas. Hyperkeratosis is formed in the areas exposed to pressure and, simultaneously, the pressure also increases in the deeper layers of tissue. The patient usually does not see these changes due to diminished sensitivity.
Foot ulcers are one of several complications that diabetes patients experience and, as nurses, are important to prevent. We can help by regular inspection of the feet if the patient has impaired sensation in the extremities. The most important preventive measure is to check inside the patients shoes every day to see if there are any foreign objects inside the shoe, since they will not be able to feel this themselves.
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