It’s good to use a dressing for a few reasons. First, it provides a barrier between your wound and the environment, helping to protect it from infection. Second, the dressing will absorb any fluid your wound produces, helping to protect your skin from becoming over moist which can make it more susceptible to damage and infection, and cause increased pain. The dressing will also prevent your wound from sticking to any compression bandaging or garment you are wearing, helping to protect delicate healing tissue and keeping your compression cleaner for longer. The dressing you use should be appropriate for your stage of wound healing. for example, a thin film dressing can be used for a shallow almost healed wound. If the skin surrounding your wound is fragile, a dressing containing silicone may avoid damage to the skin.
As you know, compression therapy is vital for healing your leg ulcer. Bandaging is usually used when the limb is swollen and/or a very large wound is present. In both cases, padding can be used to restore a cylindrical limb shape before bandaging is applied over the top, to ensure compression is delivered correctly. However, this can have the disadvantage of wearing for several days and nurse visits to change the bandaging, removing some of your independence. Remember, bandaging is only used until your limb is ready for the next phase of compression. Once swelling is reduced and your wound is smaller, and providing your limb is cylindrical in shape, you could use a compression hosiery kit, garment or wrap which will allow you to apply and remove as and when you like, for activities such as showering and bathing. Discuss these options with your clinician.
As you probably know, it is not a good idea to stop wearing your compression as it helps to keep your swelling at bay. Without it, you may see a gradual return of the swelling which will no doubt also be uncomfortable in the hot weather. A compromise is to wear a lighter garment, in a more breathable fabric. A range of differing materials and colours are available from different suppliers. For example, you may prefer a finer, skin-coloured garment for the summer months. Depending on the strength of compression recommended by your clinician, wearing a lighter garment may mean compromising on the amount of compression delivered, but this is preferable to no compression at all on hot summer days.
It is well known that mild to moderate exercise such as swimming is beneficial as it helps the muscles to pump lymph fluid through the body. Exercising while wearing compression enhances the effect. It is recommended that you wear a garment to swim. Ideally use an older garment approaching the end of its life for swimming; the chlorine will eventually have an adverse effect on the elastic fibres in the garment, and may reduce the product life of a new arm sleeve.
While in the pool you might want to also do your usual arm exercises as the water provides resistance, giving added benefit.
As with any exercise, start slowly, gradually building up as you feel able. Listen to your body and stop if your affected arm hurts.
Check your limb measurements against the manufacturer’s size chart to ensure you have the right garment for you. If the size is correct but you are having difficulty with application, an application aid might help. Alternatively, a different type of product might be more suitable for you, for example, one made of a softer fabric or with a zip fastener. Compression wraps which fasten around the limb with VELCRO® straps might also be easier to apply.
Garments roll for a variety of reasons. For example, if swelling is present, rolling may occur because the fabric is not stiff enough to contain it. Rolling will also occur if the style of the garment is unsuitable for the shape of the limb, or if the garment size is incorrect. Also consider if the top band of the garment is too narrow to achieve good anchorage.
To avoid rolling, check that your garment is made from the best material for your condition, and that it is delivering the right amount of compression. For example, a limb with lymphoedema might require a stiffer fabric to contain the swelling. Would thigh length garment suit your limb shape better? If all these factors are correct and rolling is still a problem, remeasure your limb and check your measurements against the manufacturer’s size chart to make sure they correspond with your hosiery. If the fit is correct, consider the use of a hosiery adhesive to help the top band stay in place, as long as it is not restrictive.
The garment should feel supportive on the limb, but not dig in or cause discomfort. Wearing a garment that is too tight and uncomfortable could result in damage to your skin and, in extreme cases, restrict your circulation. It is important that your limb is measured according to the manufacturer’s guidelines for the specific garment you are buying/wearing to ensure the correct size and accurate fit. Remember that your compression needs may change according to your health and the condition of your limb. For example, if swelling reduces, your garment may become loose.
If your compression garment bunches up or the fabric creases during wear, this can lead to areas of damage to the skin. It is therefore important that your garment does not wrinkle. As always, first check garment measurements are correct for your limb. For example, the garment chosen may be too long – either you or your clinician should check your measurements against the manufacturer’s leg lengths. Not all products will be the same, so find the one that fits your measurements best. If your garment is too long, don’t be tempted to fold it to solve the problem, as two layers means twice as much compression in that area. This can lead to skin damage and restricted blood flow and could result in swelling above the fold. It is much better to have a garment that fits.
When first putting on your garment each day, make sure that the material of your garment is evenly stretched over your limb, smoothing out any crinkles. A good way to smooth out your hosiery is to wear a pair of household rubber gloves and smooth out the fabric as you apply it. If this doesn’t help, you may need to consider an alternative garment.
The EPS is secure, confidential and widely used. If you currently collect prescriptions, you will no longer have to visit your GP practice to pick up your paper prescription. Instead, your GP will send the prescription electronically to us, saving you time.
You need to choose which NHS dispenser you would like to receive your electronic prescription. This is called nomination. You can nominate (choose) any NHS dispenser operating an EPS, for example, Daylong. You can ask your GP to add your nomination for you or sign up on our website or call customer services (details opposite) if you wish to nominate Daylong. You do not need a computer to use EPS.
If you prefer not to visit your GP practice every time you need to collect your repeat prescription, then EPS is for you. However, if your prescriptions are coloured purple/pink, this might mean that your prescribing clinician is not yet able to use the EPS system.
Here are some of the benefits of nominating Daylong:
If you want to change or cancel your nomination, speak to any pharmacist or appliance contractor that offers EPS, or your GP practice. Tell them before your next prescription is due that you wish to cancel EPS and get a paper prescription. This will help to ensure all goes smoothly with the switch.
The Daylong RE-Mind (Reminder) prescription service helps you know when it is time for you to get your replacement (NEW) compression garments. Like clothes that you wear daily, over time they will be become tired and worn. Our FREE service keeps you informed when it is time to change.
Your compression garments have a limited life span. After this time the armsleeve, hosiery or compression wrap may not give enough compression to control and manage your condition. Medical compression garments are usually guaranteed prescription service for either 100 washes, 6 months or 12 months. Therefore, it is important that you obtain your new replacement garments before this time.
It is recommended that before you reorder your garment that you check with your clinician to ensure that the prescription is still right for you. With time, your health can change and this may affect the compression garment you wear.
The RE-Mind Service will email you one month before your garment needs to be replaced. We will advise you about the previous product you received and provide the details necessary, e.g. name, size, colour, etc of your garment so that your clinician or GP can raise a new prescription.
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