Use of a two-layer compression system in severe bilateral leg lymphoedema with ulceration: A case report

Background: In this case report the authors present an individual with a medical history ofsevere bilateral leg lymphoedema, multiple bilateral ulceration, type 2 diabetes, and morbid obesity. Aim: To determine the efficacy ofa commercially available compression system (Coban™ 2 Compression System; 3M) on an individual with severe bilateral leg lymphoedema, and multiple bilateral ulceration. Methods: Employing the Coban 2 Compression System toe-boot bandaging technique, objective and subjective data on leg volume, tissue compositional changes and wound healing were collected at baseline and three times per week over a 4-week follow-up period. Under-bandage pressures were controlled using a pressure monitor during bandage application. Results: The patient's total limb volume decreased during treatment; circumference volume measurements showed a 3 L reduction in the left leg, and a 1.3 L reduction in the right leg. Limb volume decreased by 2.1 L in the left leg, and 2.1 L in the right. Bioimpedance spectroscopy data measured a reduction of3.2 L in the left leg and 3.0 L in the right leg. Tissue fluids reduced by 55% in the superficial tissue ofboth calves during the intervention period. The reduction of the total wound size was 21.7 cm² in the left leg and 19.95 cm² in the right leg. Conclusion: Treatment with Coban 2 Compression System improved wound healing and decreased leg volume in the present case.