[adrienurse]

lets say a hypothetical morbidly obese patient (350 lb) with severe leg edema was advised by a dermatologist to wrap his legs in a tensor like compression bandage to keep the swelling down (stockings do not work because of the girth of his legs (tend to roll down and cause more harm than good). Where would a nurse obtain such a product?

[P_RN]

Well, hypothetically, one surgeon I know uses a compression bandage called COBAN. It's like slightly sticky crepe paper but stiff enough it doesn't roll at the edges. I'm sure there are many other brands. Why do you ask?


I just remembered hearing about a veterinary product called Vet rap. It's similar to COBAN but a lot less expensive.

[oMerMero]

Ace wraps

[prowlingMA]

I would udse the widest Ace wrap available. THe Coban the previous poster mentioned tend to get hard after an hour or so and is about $5 for one time use wrap. Aces are about $5-20 for a multi use wrap.

[adrienurse]

regular ace wraps (of the thickest lidth possible) have been tried in the past on the "hypothetical" patient and the flesh on his legs only ballooned out between the layers. Seriously, he has legs like the Michelin man. Never seen such bad edema.

[NurseRotten]

Smith and Nephew has a 4-layer product called Profore. But I think it is costly.

[jetsetter]

Definitely sounds like this person needs Profore. we use on inpatients w/very good results. You really need to know what you're doing w/this product, but being a nurse I'm sure it wouldn't be that bad.
Good luck

[P_RN]

SO it's edema and not all fat? Person has lymphedema maybe? There are sites that recommend various things such as effleurage-very light finger/palm stroking distal to proximal.
http://www.cancer.gov/cancertopics/p...ge3#Section_46

I have a friend with post polio sx who has had success with these practices.

As far as coban Ive used it several times without it getting hard. You do have to be careful rolling it back up not to stretch it. And usually its not the initial layer, more like the 3rd or 4th over batting, stockinette or gauze.

[softstorms]

Go with the Profore, we have several bariatric pts, It seems to work the best. It may not be the most cost effective to begin with, but in terms of wound healing it will save you money in the long term. We have changed over from the old UNNA boot to this for all our pts.