Inelastic compression is an alternative to the popular elastic bandages in the treatment of venous ulceration. They act by improving the efficiency of the calf muscle pump and are more comfortable for the patient.
HUGO PARTSCH Elastic bandages are widely used to treat patients with venous ulceration. However, they may cause skin damage over the fulcrum areas like the anterior border of the tibia, due to their tendency to recoil like a rubber ring and to produce uncomfortable or even painful pressure during rest. Because elastic material gives way when calf muscles contract during walking, there is evidence to suggest that the pressures obtained during calf-muscle pump activity are sub-optimal.
Inelastic compression is an alternative. Such materials comprise a group of products including traditional zinc paste bandages or Unna’s boot, named after the German dermatologist, Paul Gerson Unna, short stretch bandages containing adhesive or cohesive surfaces or Velcro-band devices, which can be applied and readjusted by the patients themselves. These materials are tolerated more easily and have been shown to provide high sub-bandage pressures during calf-muscle pump activity, with a better augmentation of the venous return. Usually inelastic bandages need to be applied by well trained staff with sufficient initial pressure, taking into account an immediate pressure loss, which is more pronounced in the resting than in the upright position. Therefore, high pressure during walking is maintained for several days providing haemodynamic affectivity. Inelastic compression has a massaging effect during walking which is responsible for oedema removal, reduction of pain and inflammation and improvement of the microcirculation.