Managing patients unable to tolerate therapeutic compression.

Managing patients with venous ulceration who are unable to tolerate therapeutic compression bandaging is a challenging clinical problem. This study followed a group of 28 such patients who were treated with three layers of graduated Tubigrip as an alternative to therapeutic compression. It also investigated factors that influenced nurses in deciding to use this bandaging system. Patients were followed until their ulcers healed or for a maximum of 12 weeks. The decision to use three layers of graduated Tubigrip was based on 19 patients' desire to wear their normal shoes (67.9%) and the convenience of access to the ulcer by eight patients (28.6%) (to permit frequent dressing changes for large or infected ulcers, and for the daily application of steroidal creams to periulcer skin). Fourteen patients' ulcers had healed within the 12-week study period. The remaining 14 patients had a mean reduction in ulcer area of 4.6 cm(2) (SD = 7.4), and median of 2.3 cm(2) (range 28.5). The authors found three layers of graduated Tubigrip useful for managing patients who cannot tolerate therapeutic forms of compression.