Carlos Sánchez Fernández de la Vega*

Fingoi Centre/Primary Care-Galego Health Service, Lugo, Spain

*Corresponding Author: Carlos Sánchez Fernández de la Vega, Fingoi Centre/Primary Care-Galego Health Service, Lugo, Spain.

Received: May 29, 2023; Published: June 28, 2023

Abstract

When applying compression bandaging to a leg with a vascular ulcer, one of the biggest fears of professionals is that they may not detect severe peripheral artery disease. Measuring the ankle-arm index is a crucial diagnostic tool for the detection of this disease. According to the guidelines for treating peripheral arterial disease, compression therapy is contraindicated, without clinical evaluation by a vascular expert, when this index is below 0.80. Double focal compression bandage technique is a type of compression therapy, based on physiological principles such as arteriogenesis and angiogenesis, which uses only bandages and gauze, to obtain pressure gradients that stimulate collateral circulation in the affected area, leading to healing of the vascular ulcer. It is now recognized that compression is not a contraindication for patients whose ankle-brachial index is at least 050, but the clinical course of the ulcer should be monitored daily, in the first weeks. This article describes the clinical evolution of arterial ulcers in the legs, in five patients diagnosed with severe peripheral arterial disease, where the compression bandaging was contraindicated, according to angiologists who had already treated them. Since the various treatments had failed, I decided to use this technique, which was successful. Daily monitoring of clinical course during the first few weeks is required, to detect signs/symptoms of worsening, we taught patients how to detect them, in which case themselves would remove the bandaging and come to the medical office. The fourth case is a patient diagnosed with Leriche syndrome, who has undergone several surgeries to restore circulation in the legs. The surgical options are over, the next treatment would be amputation. We applied the technique, for 2.5 months, to reduce oedema and heal the wound of the amputated toe. The patient reduced the oedema and healed the wound, but he worsened, when he removed the bandaging, for indication of angiologist. In my opinion, this led to the amputation of both lower limbs.

 Keywords: Peripheral Artery Disease; Vascular Leg Ulcers; Compression Therapy

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Citation: Carlos Sánchez Fernández de la Vega. “Peripheral Artery Disease. Double Focal Compression Bandaging Technique". Acta Scientific Clinical Case Reports 4.7 (2023): 27-40.

Copyright: © 2023 Carlos Sánchez Fernández de la Vega. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.