Reducing Slippage of Multilayer Compression Bandages in Patients with Chronic Lipodermatosclerosis

Introduction: Patients with long-standing venous insufficiency will often develop chronic lipodermatosclerosis (LDS). LDS is a form of panniculitis, with signs and symptoms including pain, hardening of the skin, changes in skin color, swelling and a tapering of the legs above the ankle1. This proximal concomitant edema results in the legs having an “inverted champagne bottle” shape. LDS is more common in women and individuals with high body mass indexes2.

Previous practice: A variety of compression systems have been utilized to provide compression therapy for patients with LDS. Patients have reported difficulty in finding compression wraps that stay in place. The gold standard treatment is graduated compression therapy; however, the characteristics of uneven contour of the affected leg poses severe challenges to keeping compression devices in place2.

Proposed Solution: The application of a novel multilayer venous compression wrap designed to reduce bandage slippage utilizing pressure indicators and a novel knitted base layer to improve patient outcomes. The compression wrap will be used on multiple patients with a history of LDS and “champagne bottle shaped” legs. 10 patients with a history of LDS were selected to receive augmented wrapping along with a novel multilayer compression bandage. All patients had previously been treated with another form of multilayer compression.

Results: The use of a novel multilayer venous compression wrap along with additional bulk to the concave region of the leg exhibiting signs of LDS using additional padding and cotton rolls enabled the dressings to stay in place better than previously tried devices. Each patient reported the dressings had stayed in place better, there was reduced pain, and reduced slippage.

Conclusion:  Adding bulk along with the use of a novel multilayer venous compression wrap effectively reduced slippage of compression bandages in the setting of LDS. Reducing the slippage may improve patient compliance while leading to fewer complications commonly associated with bandage slippage.