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[1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension. The clinical presentation usually resembles cellulitis, however bilateral involvement is a differentiating feature.
An Unna’s boot [1] (also Unna boot) is a special gauze (usually 4 inches wide and 10 yards long) bandage, which can be used for the treatment of venous stasis ulcers and other venous insufficiencies of the leg. It can also be used as a supportive bandage for sprains and strains of the foot, ankle and lower leg.
The dressing should be changed and the wound irrigated with normal saline at least twice each day. [4] In addition, it is recommended to administer an antibiotic active against staphylococci and streptococci, preferably vancomycin when there is a risk of methicillin-resistant Staphylococcus aureus . [ 4 ]
The dressings used for the technique include foam dressings, sealed with an occlusive dressing intended to contain the vacuum at the wound site. [1] Where NPWT devices allow delivery of fluids, such as saline or antibiotics to irrigate the wound, intermittent removal of used fluid supports the cleaning and drainage of the wound bed. [6]
Knee-high stockings are more comfortable, easier to apply, and wearing them increases patients' compliance with treatment. [22] Knee-high stockings are easier to size for limb measurement than thigh-high compression stockings. [9] Thigh-high compression stockings may create a tourniquet effect and cause localized restriction when rolled down. [23]
Use of a skin graft to close a fasciotomy wound. Remove any external compression on the affected limb. [12] This includes tourniquets, orthopedic casts, or dressings. [12] Cutting the cast will reduce the intracompartmental pressure by 65%. [19] It will drop by 10 to 20% after cutting the padding. [19]