A dual compression system: preliminary clinical insights from the US
There is growing evidence on an interconnection between the venous and lymphatic systems in venous leg ulceration, and the possible effects of prolonged oedema and lymphatic impairment in delayed wound healing. Compression therapy is a widely accepted treatment for venous and lymphatic disorders, as it decreases recurrence rates and prolongs the interval between recurrences. Compression bandages improve venous return, increase the volume and rate of venous flow, reduce oedema and stimulate anti-inflammatory processes. The pressure at the interface (IP) of the bandage and the skin is related to the elastic recoil of the product used and its resistance to expansion. The pressure difference between the IP in the supine and standing positions is called the static stiffness index (SSI). Elastic materials provide little resistance to muscle expansion during physical activity, resulting in small pressure differences between resting and activity, with an SSI <10mmHg. Stiff, inelastic materials with a stretch of <100% resist the increase of muscle volume during physical activity, producing higher peak pressures, an SSI of >10mmHg and a greater haemodynamic benefit than elastic systems. UrgoK2 is a novel dual-layer high-compression system consisting of an inelastic (short stretch) and elastic (long stretch) bandage, resulting in sustained tolerable resting pressure and elevated working pressures over extended wear times. It is indicated for the treatment of active venous leg ulcers and the reduction of chronic venous oedema. Each bandage layer has a visual aid to enable application at the correct pressure level. Published European studies have assessed this compression system, exploring its consistency of application, tolerability and efficacy. This article presents the first reports of health professionals' clinical experience of using the compression system in the US, where it has been recently launched. Initial feedback is promising.
In December 2019, a panel of wound care experts (the authors) met in Fort Worth, Dallas, US, to examine the attributes of a compression system for venous leg ulcers (VLUs) that has been available in Europe for some time and was launched in the US in 2020. The dual-layer system consists of an inelastic (also known as short stretch) and an elastic (long stretch) layer; its primary purpose is to heal VLUs. The product has already been the subject of a number of clinical studies conducted in Europe to assess its efficacy, tolerability, comfort, ability to maintain pressure over an extended period, ease of use and ability to be applied in a consistent manner.1,2,3,4 The panel reviewed the evidence in the context of other compression systems on the market; here, they share their personal experience of using the product and assess whether it could be effective as a treatment for venous leg ulcers. This report summarises the evidence and discusses their findings.
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