Exploring Adjustable Compression Wraps: Applications and Multifaceted Benefits
This MOH Focus reviews the scope of application as well as the benefits of adjustable compression wraps. This paper is available to download in English, French, German, Italian, Polish and Spanish.
What are wraps?
Adjustable compression devices with inelastic properties.
When are they used?
For the management of lymphedema, chronic venous insufficiency and lipedema.
What makes them so special?
The combination of material attributes (high working pressure, low resting pressure) and design properties (self-adjustability) offers many benefits over conventional bandages (References 1-20).
Benefit 1: self-management
Self-application
- Easy and quick self-application by patient or caregiver
- Ideal for patients with limited access to care centers
Self-adjustment
- Patient can tighten wraps when they loosen due to edema reduction
- Possibility to loosen in case of discomfort
- Better pressure maintenance over time
Self-hygiene & skin care
- Wrap and liner can be easily removed and washed if needed
- Hygiene and skin care can be performed at home and more regularly
Benefit 2: enhanced treatment efficacy (upper & lower limbs)
Lymphedema
- Effective edema reduction & maintenance
- Maintenance of appropriate compression lovel
- Reduced pain & heaviness
- Increased mobility
- Improved skin integrity
- Improved leg shape
- Greater limb volume reduction compared to bandages despite same initial pressure
Venous leg edema & ulcers
- Improved venous return (high static stiffness index)
- Effective edema reduction
- Reduced pain
- Fast ulcer healing rate, prevention of ulcer recurrence
- Improved skin integrity & density
- More effective than bandages in reducing edema & healing ulcers
Lipedema / lipolymphedema
- Reduction in leg volume
- Tissue support
- Increased mobility, decrease in discomfort and pain (based on observational reports)
Liposuction
- Effective volume reduction in the management of post-operative edema after liposuction
Benefit 3: cost-effective
Direct cost savings – material saving:
- Wraps are washable & reusable
- Material costs for wraps versus bandages met after approximately one month = cost effective despite initial outlay
Indirect cost savings – time saving:
- Self-application: fewer clinic visits, more time available for the clinician to perform manual lymph drainage & skin care
- Application/handling quick & easy to learn by clinicians & caregivers
Benefit 4: enhanced quality of life
- Increased comfort (low resting pressure) while being effective
- Improved gait, stability & mobility
- Nicer cosmetiv appearence and less bulky than bandages
- Normal clothes and shoes can be worn again
- Improved wound care
- Enhanced independence, confidence & satisfaction
- Improved psychosocial aspects
- Increased concordance & compliance
Take-home message
Wraps do not only improve the clinical outcome of lymphedema and CVI patients, but they also clearly increase their quality of life through autonomous handling and self-management while being comfortable, hygienic and cost-effective.
References
(1) Campanholi, L.L., Lopes, G.C., Mansani, F.P., Bergmann, A. and Baiocchi, J.M.T., 2017. The validity of an adjustable compression velcro wrap for the treatment of patients with upper limb lymphedema secondary to breast cancer: a pilot study. Mastology (Impr.), 27(3), pp.206-212.
(2) Caprini, J.A., 2015. Commentary on ‘Adjustable Velcro Compression Devices are More Effective than Inelastic Bandages in Reducing Venous Edema in the Initial Treatment Phase: A Randomized Controlled Trial’. European Journal of Vascular and Endovascular Surgery, 50(3), p.375.
(3) Cooper-Stanton, G., 2019. Adjustable compression devices for chronic oedema and lipoedema: purpose, selection and application. British journal of community nursing, 24(6), pp.278-282.
(4) Damstra, R.J. and Partsch, H., 2013. Prospective, randomized, controlled trial comparing the effectiveness of adjustable compression Velcro wraps versus inelastic multicomponent compression bandages in the initial treatment of leg lymphedema. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 1(1), pp.13-19.
(5) Ehmann, S., Whitaker, J.C., Hampton, S. and Collarte, A., 2016. Multinational, pilot audit of a Velcro adjustable compression wrap system for venous and lymphatic conditions. Journal of wound care, 25(9), pp.513-520.
(6) Everett, J., 2016. The use of pressure wraps in treating lymphoedema in care. Nursing and Residential Care, 18 (8).
(7) Lawrance, S., 2008. Use of a Velcro® wrap system in the management of lower limb lymphoedema/chronic oedema. Journal of Lymphoedema, 3(2), pp.65-70.
(8) Lee, N., 2018. An evaluation on the use of adjustable compression wrapping devices as an alternative to compression bandaging in lower leg wounds. Wounds International, 9(4), pp.12-19.
(9) Lee, N. and Lawrence, S., 2017. Haddenham easywrap: the latest innovation in the management of lymphoedema. British journal of community nursing, 22(5), pp.14-21.
(10) Lee, N. and Lawrance, S., 2019. Haddenham Easywrap: an alternative to compression bandaging in chronic oedema and wound care. British journal of community nursing, 24(4), pp.22-28.
(11) Lurie, F., Lal, B.K., Antignani, P.L., Blebea, J., Bush, R., Caprini, J., Davies, A., Forrestal, M., Jacobowitz, G., Kalodiki, E., Killewich, L., Lohr, J., Ma, H., Mosti, G., Partsch H., Rooke, T. and Wakefield I. 2019. Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 7(1), pp.17-28.
(12) Mestre, S., Calais, C., Gaillard, G., Nou, M., Pasqualini, M., Amor, C.B. and Quere, I., 2017. Interest of an auto-adjustable nighttime compression sleeve (MOBIDERM® Autofit) in maintenance phase of upper limb lymphedema: the MARILYN pilot RCT. Supportive Care in Cancer, 25(8), pp.2455- 462.
(13) Mosti, G. and Partsch, H., 2017. Self-management by firm, non-elastic adjustable compression wrap device [Translation of Druckmessungen unter Klettverschluss-Kompression-Selbstbehandlung durch feste, unelastische Beinwickelung]. Veins and Lymphatics, 6(3), pp.88-90.
(14) Mosti, G., Cavezzi, A., Partsch, H., Urso, S. and Campana, F., 2015. Adjustable Velcro® compression devices are more effective than inelastic bandages in reducing venous edema in the initial treatment phase: a randomized controlled trial. European Journal of Vascular and Endovascular Surgery, 50(3), pp.368-374.
(15) Giovanni, M., Stefano, M., Sergio, B., Simone, S., Luca, G., Matteo, B., Roberto, P., Fabrizio, M., Bastiani, L., Hugo, P. and MIRACLE Trial investigators, 2019. Adjustable compression wrap devices are cheaper and more effective than inelastic bandages for venous leg ulcer healing. A Multicentric Italian Randomized Clinical Experience. Phlebology. 0(0), pp.1-10.
(16) Partsch, H., 2019. Reliable self-application of short stretch leg compression: Pressure measurements under self-applied, adjustable compression wraps. Phlebology, 34(3), pp.208-213.
(17) Thomas, S., 2017. The use of compression wraps in the management of lymphoedema. Journal of Lymphoedema, 12(1), pp.32-38.
(18) Williams, A., 2016. A review of the evidence for adjustable compression wrap devices. Journal of wound care, 25(5), pp.242-247.
(19) Wounds, U. K. Best practice guidelines: the management of lipoedema. London: Wounds UK, 2017.
(20) Schofield, A., 2019. ReadyWrap®: case studies in practice. British Journal of Community Nursing, 24(10), pp.24-31