Use of layered compression bandages in diabetic patients. Experience in patients with lower leg ulceration, peripheral edema, and features of venous and arterial disease.

Layered compression therapy for venous leg ulcers and ulcers associated with chronic leg edema has been shown to be an effective treatment in patients with adequate arterial circulation. However, no study has looked specifically at compression therapy in the diabetic population. This clinical case review examines outcomes in two groups of diabetic patients with edema and either venous ulcers or preulcerative conditions. Patients in Group 1 had clinically adequate arterial circulation and were treated with a four-layer compression bandage system. The highly elastic third layer was eliminated in the Group 2 patients, who had compromised peripheral arterial circulation. Healing occurred in 81% of patients in Group 1 and 67% of patients in Group 2. There was no acute progression of lower limb ischemia. Layered compression therapy was an effective and safe treatment in this diabetic population with adequate arterial circulation. Reduced compression also can be helpful in some patients with arterial compromise.