Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

  1. The treatment of choice for venous ulceration uncomplicated by other factors is graduated compression bandaging, properly applied and combined with exercise.
    • In venous ulceration, high compression achieves better healing than low compression.(High compression therapy should be applied if ABPI is 0.08 or greater)
    • Compression bandages should only be applied by a suitably trained and experienced practitioner.
    • The concepts, practice, and hazards of graduated compression should be fully understood by those prescribing and fitting compression stockings.
    • Ankle circumference should be measured at a distance of 2.5 cm (one inch) above the medial malleolus.
  2. External compression applied using various forms of pneumatic compression pumps  can be indicated for individuals with chronic venous insufficiency.
  3. The client should be prescribed regular vascular exercise by means of intensive controlled walking and exercises to improve the function of the ankle joint and calf muscle pump.