Four-layer bandage versus short-stretch bandage in the treatment of venous leg ulcers

Abstract

Overview of the topic: Four-layer bandage was found to heal Venous Leg Ulcers (VLUs). The biggest difficulty is that patients refuse four-layer bandages in summer in Malta because of high temperatures. According to new research, short-stretch bandages are similar to four-layer bandages when treating VLUs (De Carvalho, et al., 2018 & Porsch, et al., 2001). Thus, it seems that the use of a short-stretch bandage in patients with venous leg ulcers will help, but more study is required to confirm its usefulness. Aim: The purpose of this study was to compare the effectiveness of a four-layer bandage versus a short stretch bandage in patients with VLUs. Research question: In patients with VLUs, is the application of four-layer bandaging more effective than short-stretch bandaging in providing better healing? PICO elements: Population (P): Patient with venous leg ulcers. Intervention (I): Four-layer bandage. Comparison (C): Short-stretch bandage. Outcome (O): Providing better healing. Method of Appraisal: Various electronic databases were searched to conduct a systematic literature review. An inclusion and exclusion criteria was formulated to select studies relevant to this study PICO question. Studies of good quality, in full text and published in the English were selected. A total of 2 SRs with MA and 5 RCTs were selected. The CASP tools for SRs with MA and for RCTs by Guyatt, Sackett and Cook, (1994) were utilised as a critical appraisal tool. Ethical issues were also considered. Results and Conclusion: A SR with MA and 2 RCTs revealed that using a short-stretch bandage helped to heal venous leg ulcers. In another SR with MA and 3 RCTs, findings showed that four-layer bandages were proven to be more effective in the treatment of VLUs. Implications and Recommendations: More local studies are needed to evaluate if short-stretch bandages are more effective than four-layer bandaging in treating VLUs. Another recommendation was that health care professionals should continue their education in the treatment of VLUs in order to keep their practice abreast with evidence.