Unna boot

  1. 0
    What is the correct way to apply an unna boot? Is it acceptable to wrap up the leg toward the knee and to continue back down the leg to the ankle?
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  3. 18 Comments so far...

  4. 4
    First of all, the correct terminology is Unna's Boot.
    Second, no it is not acceptable to go back down the leg. to

    First, you clean the skin thorougly, then flex the knee. NExt, position the foot at a right angle to the leg, wrap firmly but not tightly around the foot starting right above the toes. make sure the heel is covered. continue wrapping upward overlapping each layer by 50 percent with each turn. make sure the dressing circles the leg at an angle to avoid compromising the circulation. smooth the boot with your free hand as you go. stop wrapping about an inch below the knee. wrap a kerlix roll around the boot to absorve drainage, then finally wrap with an ace wrap in a figure eight pattern. if after hardening, constriction develops, cut a 2 inch slit in the top of the boot.

    additional info to know: the way the boot works is when ambulation occurs. the calf muscle contractions are key. as walking occurs, the rigid dressing restricts the outward movement of the calf muscle thereby directing the contraction force inward and improving venous circulation. obviously, a bedridden patient would not much benefit from the unna's boot. if firmness against the ulcer itself is uncomfortable, it may be beneficial to cover the ulcer with duoderm or foam first before applying Unna's boot.

    Hope this helps someone.
    MommaNurse26, AKAKatydid, melpn, and 1 other like this.
  5. 0
    Here's a link. Very informative posts. Thanks.

    http://www.fpnotebook.com/SUR117.htm
  6. 0
    Hi, bethroew!

    Unna's boot (and, by the way, I call it an Unna boot, too!) and I are old friends as I have a tendency to develop stasis ulcers in one leg secondary to phlebectomies that were done for varicose veins. My very handsome vascular surgeon applies them pretty much the way nursbaybie described, but without the outer ACE wrap. The zinc oxide that is in the gauze protects my healthy skin if the ulcer starts to drain. The first one that was applied scared me a bit because it was on for over a week and I was worried about what was going on with the ulcer. I was pleasantly surprised when it was removed.

    Welcome to allnurses!
  7. 0
    I see that this thread is on the application of Unna's boots. I also have a question about application. We just received an order to apply 10 layers of unna's boot! I have never heard of this and am wondering if this is in any way contraindicated. Thank you, Jan
  8. 1
    Quote from gerikt
    I see that this thread is on the application of Unna's boots. I also have a question about application. We just received an order to apply 10 layers of unna's boot! I have never heard of this and am wondering if this is in any way contraindicated. Thank you, Jan
    ummm, I would question that order. LOL! I believe that would be called a cast!
    SappyRN likes this.
  9. 0
    We have had some Unna's boots donated to take to the villages in the Dominican Republic. I see they can be left on a week -- useful for even sprains and edema. Question: can these be safely used for unsupervised patients? We go to villages one day and then leave. We always give good instructions in Spanish. Besides checking circulation, what other risks do we warn patients about? Thanks, Jan from WA state
  10. 0
    Yes Unna Boots can be left in place unsupervised for up to a week as long as they are applied correctly. It would be wise to instruct the patient to remove the dressing if they experience pain that is unrelieved with elevation, or have an increase in shortness of breath. Use unna boots with caution in patient's that have known congestive heart failure, since the unna boot is a compression dressing it can cause a fluid overload in some fragile heart patients. Good luck! Where in the DR are you located at? I am hoping to visit there in December doing some medical mission work.
  11. 0
    I am trying to educate myself on wound dressings. I have applied Unna's Boots but after reading this find I was applying them incorrectly. But I'm wondering about the Unna's Boots we have at my facility. If I wrapped them tightly the outer edge (long edge) of the dressings would be much tighter than the inside edge. Because of this I have wrapped loosely because I was afraid of the edges creating a constricting string (for lack of a better word) around the patients leg.

    I also see these should be used on walking patients, in the cases I have applied them they were on wheelchair bound patients. Is there any benefit in this case?
  12. 0
    Can Unna's boot be applied over blistered areas?


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