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The use of a novel compression wrap, the Dual Compression System (DCS), in the management of edema associated with diabetic ulcers.
Introduction: The use of compression in controlling venous reflux is well known. Less well known is the use of the compression wraps in the management of edema associated with diabetic ulcers, which may or may not be combined with venous conditions. The use of compression wraps to control edema and reduce venous congestion could facilitate wound healing by improving microcirculatory skin changes associated with diabetes.
Also, of critical importance for treatment of diabetic foot ulcer is the use of knee high offloading boots which many times is not possible with an edematous limb. The availability of a low profile, two layer bandage that provides high compression in both layers, yet is deemed comfortable by patients have made management of edema associated with diabetes quite facile in our clinic.
Methods: We present a case series of patients whose clinical problem of immediate concern was the edema associated with diabetic ulcers, which in some can prevent the application of the highly recommended total contact casts. We applied the DCS to diabetic ulcer patients and monitored them for reduction of edema both via measurements of limb diameter, as well as photographically. Adequate levels of perfusion was established in each case before compression was applied.
Results: We report that the patients reported comfort during the DCS wear period, and in each case, we could achieve edema control. In one case, we actually applied a Total Contact Cast (TCC) over the bandage, attempting to achieve both edema and pressure reduction.
Discussion: Edema reduction can aid wound healing in diabetic ulcers, however, and the use of compression to achieve this goal is described in literature but likely not highly practiced clinically. One concern that the new compression wrap (DCS) alleviates is the potential reduction of perfusion to harmful levels due to improper wrapping of the bandage. This potential is reduced due to the novel design of the DCS.
References
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