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. 2021 Mar 25;14(1):46-51.
doi: 10.3400/avd.oa.20-00159.

Use of Sponge-Foam Inserts in Compression Bandaging of Non-Healing Venous Leg Ulcers

Rica Tanaka  1   2 , Hideaki Inoue  3 , Takeru Ishikawa  3 , Yuichi Ichikawa  1 , Rumiko Sato  1 , Azusa Shimizu  1 , Hiroshi Mizuno  1
Affiliations

Use of Sponge-Foam Inserts in Compression Bandaging of Non-Healing Venous Leg Ulcers

Rica Tanaka et al. Ann Vasc Dis. .

Abstract

Objective: Venous leg ulcers (VLUs) caused by chronic venous insufficiency are difficult to treat. Outcomes after compression therapy and the current standard of care often used in conjunction with other options vary widely. We examined the effects of foam inserts on sub-bandage pressures in patients with VLUs and compared use of foam inserts in elastic and inelastic compression bandaging. Methods: Six patients (≥20 years old) with VLUs and skin perfusion pressure >40 mmHg were included. Each patient underwent weekly treatment regimens of debridement, dressing changes, and dual sponge-insert application followed by elastic (n=3) or inelastic (n=3) compression bandaging. The median resting sub-bandage pressures of the ulcer beds, wound sizes, and healing percentages were recorded. Wound beds were biopsied before and after treatment for histological assessment. Nine healthy volunteers served as controls during preliminary testing. Results: With proper sub-bandage pressures (>35 mmHg), the average healing time was 88.0±66 days, which was shorter than anticipated (i.e., ≥6 months). Combining large and local sponge-foam inserts increased sub-bandage pressures regardless of the compression bandage selected, with marked improvements seen in deeper wounds. Conclusion: Layering one or two sponge-foam inserts beneath compression bandages facilitates uniform and optimal wound-bed pressure, which accelerates the healing of VLUs.

Keywords: compression therapy; sponge-foam inserts; venous leg ulcers.

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Conflict of interest statement

Disclosure StatementHideaki Inoue and Takeru Ishikawa are employees of Alcare Co. Rica Tanaka, Yuichi Ichikawa, Rumiko Sato, Azusa Shimizu, and Hiroshi Mizuno have no conflicts of interest to declare.

Figures

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Fig. 1 Schematic of the study design.
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Fig. 2 Placement of large and local sub-bandage sponge-foam inserts.
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Fig. 3 Sub-bandage pressure exerted on affected sites using inelastic tension-guided bandages (Elascot-TG; n=3) or elastic bandages (up bandage; n=3), without or with sponge inserts (large and local foams) for (A) shallow ulcers and (B) deep ulcers.
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Fig. 4 Patient #1: Weekly photos of the ulcer of the right ankle (A–D) and 1 week after skin graft (E). Note the progressive reduction in leg edema and revitalization of tissues that promote wound healing. Dual-layer sponge-foam inserts (F) are illustrated on the right.
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Fig. 5 Patient #2: A large, indurated, and hyper-pigmented ulcer of the left ankle (left) and the well-healed grafted site (right), with no signs of imminent recurrence.
See this image and copyright information in PMC

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References

    1. Dabiri G, Hammerman S, Carson P, et al. Low-grade elastic compression regimen for venous leg ulcers—an effective compromise for patients requiring daily dressing changes. Int Wound J 2015; 12: 655-61. - PMC - PubMed
    1. Gschwandtner ME, Ehringer H. Microcirculation in chronic venous insufficiency. Vasc Med 2001; 6: 169-79. - PubMed
    1. Vincent JR, Jones GT, Hill GB, et al. Failure of microvenous valves in small superficial veins is a key to the skin changes of venous insufficiency. J Vasc Surg 2011; 54 Suppl: 62S-69S.e3. - PubMed
    1. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation 2014; 130: 333-46. - PubMed
    1. Milic DJ, Zivic SS, Bogdanovic DC, et al. Risk factors related to the failure of venous leg ulcers to heal with compression treatment. J Vasc Surg 2009; 49: 1242-7. - PubMed