Ep5 - Let's start measuring up compression

Two Echidnae Wound Care Podcast with Monika and Donna

Compression, the topic everyone has experience with, an opinion on, and something to learn - including us. This will be the first episode of many on compression because there is so much to unwrap. We would love to hear your feedback on this one as we touch on so many points.

Timestamps:

00:00 Introduction

01:00 How lymphoedema training has informed our practice as wound consultants

02:11 Looking wholistically at hard-to-heal wounds through a lymphoedema lens

02:33 Clearing oedema in proximal body parts first before moving oedema in the legs

03:10 Assessing oedema

03:32 The problem of less research and experience in non-cancer related chronic oedema than cancer-related

04:14 Location and distribution of fibrotic tissue composition

05:05 Lymphoedema wound nurses the outliers

06:42 Where are the compression companies at wound management events?

07:55 Wound clinicians without lymphoedema training do not understand compression prescription in chronic oedema

08:09 Prioritising lymphatic function and compression over wound hygiene, including debridement

10:12 Reluctance of some allied health professionals to apply lower limb compression in the presence of wounding

11:22 Practice gaps in wounds and compression prescription

12:54 Motivation to understand more about lymphoedema

13:51 Myth of venous oedema being different to lymphoedema

14:00 More on reluctance to treat chronic oedema when wounds present

14:48 Lymphoedema escalation pathway

15:11 Becoming a lymphoedema mentor

15:43 Self-care in lymphoedema

16:18 The gaps in staging lymphoedema

16:40 Inadequate compression prescription, application and troubleshooting leading to bad patient experiences and money down the drain

17:36 What do we mean by the term “tolerating” compression?

21:34 Using the term” they don’t tolerate” compression when it is the healthcare system that is intolerable

22:09 The S.T.R.I.D.E. document to guide compression selection

23:11 Practical considerations when using S.T.R.I.D.E. principles

25:36 Round versus flat knit garments

27:31 Wound lymphoedema clinicians have two computers of formulary open simultaneously

28:52 More on round versus flat knit

30:47 Muffin-topping a red flag that compression needs to be applied into the thigh or higher

32:19 The Australasian Lymphology Association resources and courses

32:56 When nurses speak the same language around wounds and chronic oedema

34:38 Prioritise leg hygiene, understanding chronic oedema before debridement and dressings

36:38 The influence of industry on the science, education and clinical practice of wound management

Resources mentioned:

• STRIDE document https://lymphoedemaeducation.com.au/wp-content/uploads/2019/07/S.T.R.I.D.E.-Professional-Guide-to-Compression-Garment-Selection-for-the-Lower-Extremity.pdf (if you’re curious what STRIDE stands for, it’s Shape, Textile Type, Refill, Issues, Dosage, aEtiology)
• Australasian Lymphology Association https://www.lymphoedema.org.au/

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Disclaimer:

The views expressed in this podcast are our own. This podcast is intended specifically for healthcare professionals. Always follow your organisation's policies and procedures. Please consult your own healthcare provider for individual wound advice.