title: Treatment of Chronic Venous Ulcers Using New Four Layers Compressive Bandage Dressing.
abstract: BACKGROUND
  Lower-extremity ulcers represent the largest group of ulcers presenting to an outpatient department. It is a cumbersome, difficult to treat disease, which causes high morbidity and huge cost for the patient and healthcare system. Current standard treatment includes compression therapy.  However, majority of patients need long term treatment with minimal efficacy. Aim of our study is to evaluate efficacy of four layers compressive bandages for the management of chronic venous ulcers.
  
  
  METHODS
  In Group A, we have prospectively included 20 patients with chronic venous ulcers on lower limbs for four layers hosiery bandage using Velfour bandage. Other 15 patients, Group B, were treated with conventional wound dressing. Velfour and crepe bandage were done once weekly for three weeks.
  
  
  RESULTS
  DVT was cause of chronic venous ulcer in 70% patient in group A and in 73.3% in Group B. Majority of patients were having left sided chronic venous ulcers. The mean duration of the ulcers was 15.6 vs 10.86 months (group A vs. group B). At the end of 3rd week, in 55% wounds in Group A were healed except few big and deep wounds remained. Most of these wounds also became smaller with minimal discharge. Size of wounds significantly decreased in Group A vs. Group B patients (0.7±0.81 cm vs. 1.73±0.77 cm, p<0.00031). However, cost of treatment in group A remained higher than group B.
  
  
  CONCLUSIONS
  Our study has shown that four layer compressive bandage using Velfour is an easy, effective, and reproducible method of treatment for the chronic venous ulcer.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Chitwan, Nepal.
authors.forename: K K
authors.initials: KK
authors.lastname: Tiwari
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Chitwan, Nepal.
authors.forename: K G
authors.initials: KG
authors.lastname: Shrestha
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Chitwan, Nepal.
authors.forename: B
authors.initials: B
authors.lastname: Sah
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, College of Medical Sciences, Teaching Hospital, Bharatpur, Chitwan, Nepal.
authors.forename: D J
authors.initials: DJ
authors.lastname: Reddy
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages / Q000191:economics; D002908:Chronic Disease; D058128:Compression Bandages / Q000191:economics; D017719:Diabetic Foot / Q000150:complications; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014647:Varicose Ulcer / Q000209:etiology / Q000628:therapy*; D020246:Venous Thrombosis / Q000150:complications; D014945:Wound Healing
keywords: compression bandage; treatment; venous ulcer.