Abstract
Chronic venous insufficiency can lead to recalcitrant leg ulcers. Compression has been shown to be effective in healing these ulcers, but most products are difficult to apply and uncomfortable for patients, leading to inconsistent/ineffective clinical application and poor compliance. In addition, compression presents risks for patients with an ankle-brachial pressure index (ABPI) <0.8 because of the possibility of further compromising the arterial circulation. The ABPI is the ratio of systolic leg blood pressure (taken at ankle) to systolic arm blood pressure (taken above elbow, at brachial artery). This is measured to assess a patient's lower extremity arterial perfusion before initiating compression therapy.1. Using materials science, two-layer compression systems with controlled compression and a low profile were developed. These materials allow for a more consistent bandage application with better control of the applied compression, and their low profile is compatible with most footwear, increasing patient acceptance and compliance with therapy. The original 3M™ Coban™ 2 Layer Compression System is suited for patients with an ABPI ≥0.8; 3M™ Coban™ 2 Layer Lite Compression System can be used on patients with ABPI ≥0.5. Both compression systems are composed of two layers that combine to create an inelastic sleeve conforming to the limb contour to provide a consistent proper pressure profile to reduce edema. In addition, they slip significantly less than other compression products and improve patient daily living activities and physical symptoms. Both compression systems are indicated for patients with venous leg ulcers, lymphedema, and other conditions where compression therapy is appropriate. As with any compression system, caution must be used when mixed venous and arterial disease is present to not induce any damage. These products are not indicated when the ABPI is <0.5.
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