Compression has been the mainstay of therapy for venous ulcers, and with good reason. Compression has been shown to have a clear benefit over no compression. Moreover, the evidence suggests that a high level of compression (>25 mmHg) lends a clear benefit over low-level compression. Therefore, treatment with minimally compressive bandages, while better than nothing, is less than ideal. Depending on location and the skill of the provider, different types of high-compression bandage (Unna boot, multilayer elastomeric compression) can be used effectively. The method used to apply these bandages is important, and there is some suggestion that the ability to apply compression bandages effectively varies widely among nurses. Compression therapy should not be used in patients with an impeded blood supply to the lower extremities, whether from diabetes or arterial disease. Infection, however, has not been shown to be a contraindication to compression.
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