How Thigh Applied Intermittent Pneumatic Compression Can Improve Lower Extremity Wound Healing

Introduction: Venous Leg Ulcers (VLUs) are difficult to treat due to the challenge of edema and the result of chronic venous insufficiency (CVI) and lymphedema. Patients report a decreased quality of life due to pain, exudate management, and odor control issues. WOC nurses must utilize adjunct therapies to improve VLU wound healing and quality of life indicators.Methods:The gold standard treatment for VLUs is multi-layered compression bandaging. Multi-layered compression dressings may be fraught with issues; pain, discomfort, and exudate can cause poor patient compliance. Intermittent Pneumatic Compression (IPC) has been shown to improve circulation to lower extremity wounds and is often under-utilized. Patients report pain and difficulty applying full limb garments; thus, compliance is low. A new three-segmented thigh applied IPC device compresses the thigh from distal to proximal in two phases: active and rest and can be used in conjunction with multi-layered bandaging compressing away from the wound site.Results:Three unique case studies utilizing multi-layered compression bandaging and thigh applied IPC demonstrate ease of application and use, as well as decreased pain, edema and improved wound healing to the lower extremity wound. The case studies demonstrate how the thigh applied IPC works differently than full limb compression; utilizing a hyperemic response during the rest phase after compression that increases the arterial and venous velocity, thus improving VLU healing.Discussion: WOC nurses need to broaden awareness of adjunct therapies used in addition to multi-layered compression to improve VLU healing and quality of life indicators in patients with VLUs. Thigh applied IPC is an easily applied adjunctive therapy that decreases pain, edema, and can improve wound healing for hard to heal lower extremity wounds.References:Ratliff CR, Yates S, McNichol L, Gray M. Compression for lower extremity venous disease and lymphedema (CLEVDAL). Journal of Wound, Ostomy & Continence Nursing. 2022;49(4):331-346. doi:10.1097/won.0000000000000889 Ratliff CR, Yates S, McNichol L, Gray M. Compression for primary prevention, treatment, and prevention of recurrence of venous leg ulcers. Journal of Wound, Ostomy & Continence Nursing. 2016;43(4):347-364. doi:10.1097/won.0000000000000242 Alvarez OM, Wendelken ME, Parker R, Markowitz L. Faster healing and a lower rate of recurrence of venous ulcers treated with intermittent pneumatic compression: results of a randomized controlled trial. . Eplasty. 2020;20(e6). Morris RJ, Ridgway BS, Woodcock JP. The use of intermittent pneumatic compression of the thigh to affect arterial and venous blood flow proximal to a chronic wound site. International Wound Journal. 2020;17(5):1483-1489. doi:10.1111/iwj.13418 Naik G, Ivins NM, Harding KG. A prospective pilot study of thigh‐administered intermittent pneumatic compression in the management of hard‐to‐heal lower limb venous and mixed aetiology ulcers. International Wound Journal. 2019;16(4):940-945. doi:10.1111/iwj.13125