www.wcei.net Wound care Education Institute Instructor Cindy Broadus RN demonstrates the application of an Unnas Boot. For more information about becoming Wound Care Certified, log on to www.wcei.net
She's applying it too tightly and the foot was not at a 90 degree angle when she applied around the ankle! She didn't need to wrap so tightly because the boot dries and slightly shrinks. The way she wrapped would cause alot of discomfort for the wearer.
Her wrapping is PERFECT. Unna boot wearers are supposed to be instructed to WALK a bit to keep them from being tight. It is an entire mechanism that works as a system. As a wound nurse for decades with a very high heal rate , I can tell you this video is ABSOLUTELY CORRECT. It's only when people introduce incorrect technique that these things stop working....
No sry I totally disagree I don’t care how long u have been a wound care nurse the way she wrapped would have me at home losing my mind cutting it off. And if u properly secure a Co-ban (3m brand particularly) then there is no need for tape. Frankly I feel an unna wrapped with pleats makes it more comfy but less secure and an unna just wrapped no pleats tends to be a little uncomfortable Because you swell up requiring elevation NOT More WALKING or more use of the extremity lol that’s the craziest I’ve ever heard my team always encourages elevating over the heart 30 min to an hour daily but especially if any signs of Edema. I also feel like it’s always the ppl who don’t have to wear it always trying to preach how it should be wrapped which you don’t feel the pain us wearers suffer from idc how many centuries you have been a wound care nurse I’m glad you are no where near Massachusetts lawd lmao. Sry but this drives me nuts I’m going on a year of these dumb boots and I’m enraged with the world by now.
beautifulmuLAta totally agree with you. I am also a wound care nurse and would never dream of sending my pt out the door like that. You could see the bulges in the skin already from it being so tight. Pts would definitely be cutting it off and complaining. There would be ridges in the skin all the way down the leg when you took it off and possible cuts depending on the patients skin. I see it time and time again when people outside our clinic wrap our patients. It frustrates me to no end and I’m not the one wearing it!!
@@ashtri0824 Patients with edema typically NEED restriction. If the leg starts to swell, elevate it. But you can’t let that swelling get started, because the skin will tear. I suppose you could wrap it a bit loose and put a tension sock over it. That can be removed for comfort without ruining a perfectly good Unnaboot. But that’s not how our Wound Center technicians do it.
The foot should be at a 90 degree angle, it's hard to believe this video is produced by an education org. The leg should be cleaned also and lotion applied etc. My heart goes out to the patients who will end up wrapped in this manner.
Pleating is optional. There is no evidence on pleating- my opinion is that if it increases compression compliance via comfort, then proceed with pleating. Otherwise, non-pleated application is the standard. I would guess I apply 20% without pleats and the remainder with pleats based on the patient's tolerance of compression. I would suggest that the wrap continues to the pretibial notch or two fingers below the patella to capture the calf fat. Unna's work via calf muscle assist when walking and must be applied to the standard height. If the wearer cannot tolerate the wrap at the proper level then consider different commpression- wrapping injuries (pressure injuries) happen all the time when stopped short on the leg. Non ambulatory wearers will have some benefit but only through static compression.
but it's not ointment, they put a dressing directly on the wound that has strong medicine that releases slowly like the acticoat 7-day barrier dressing.
She is applying it wrong. She didn't put any folds in any of her rounds as she was wrapping. I am glad it is not me having to have her application of this product.
For those that disagree or feel the need to criticize im just curious as to how many CEUs you all have in wound care how many and how often are you attending wound conferences yearly and are you you following standards of care and researching???? Evidence based practice ......you can be certified all day but if you don’t have common sense or follow the guidelines along with proper technique and experience what your doing is in vain ijs.. everyone has an opinion but we all need to research because facts will stand in court all day long not what u think how it should be or what joe blow showed u hope this helps
I know plenty of people who make a big deal about collecting CEUs, with degrees, who think that makes them sources of absolute information. Yet, many of these folks can't even dress a wound correctly. Sure, they know the theory, but practical application of same isn't what they're any good at. Doing a demonstration, doesn't always mean that they actually know what they are doing. These are classroom 'paper warriors'.
It should be done prior to to know how much and the proper compression to use this is a skills demonstration they aren’t going into all of the specifics just showing you how to apply an unna and dukes boot
I am a patient…. This video should be removed from RU-vid. A similar incorrect wrap was made to my right leg several times by one of the many so called wound care nurses I have encountered over the years. I have venous insufficiency and Lymphedema. It is much worse in my right leg. Many times there is severe wound drainage and severe swelling. This particular incorrectly applied wrap resulted in my requiring to be admitted to the hospital as the too restrictive bandage caused deep cuts to the top of my foot (instep) where it bends for movement. The cuts were all the way to the tendons. I was in the hospital for 7 days and many weeks in a physical therapy center for rehabilitation. There was no dressing applied to my wounds or moisture applied to my severely dry skin. There was no padding applied before the Coban and the Coban was stretched too tightly. My complaints were ignored and the care nurse refused to listen to my concerns or needs and avoided me. After I was admitted to the physical therapy facility, there was no lymphatic followup or massage given to me for either of my legs. It was prescribed by the hospital. My left leg got worse. They refused to give me a moderate compression sock for my left leg. A good portion of the medical community has no idea about Lymphedema or how to apply proper compression bandages, even doctors. I have had so many incidents such as huge blisters developing, terribly restrictive wraps I have had to remove, etc, over the years that led me to ongoing education for myself in proper wound care. I wish I could wrap myself but it is impossible. When I tell the nurse what I need based on years of being a patient they do not listen and get defensive. If a patient is not rich and cannot go to get proper care we are stuck. Instead of getting better over the years my skin has gotten worse. My very dry and venous eczema skin is not cleaned or moisturized prior to bandaging. When I ask that it be done the majority of nurses will not do it or get annoyed when I insist ……. why dont they realize that all that dead skin needs to be removed so my skin can heal properly? When it is done, layers of the skin and dried oozing from the wounds comes off and my skin looks and feels good. When my ulcered legs temporarily heal until the next outbreak, I take care of my skin properly. Then after the next ulcers its back to improper skin care during the wraps. It’s never ending and saddening. The first time, 7 years ago after I was released from the hospital I was referred to an out patient clinic. I was assigned to a young nurse for followup and ongoing wound care as needed. My venous ulcered leg which was still not in very good shape and was healing was unwrapped by the nurse. She went to her cabinet and brought a bottle of peroxide. I asked her what she had and what she was doing and she said she was going to cleanse my leg with the peroxide. I said, ‘No way. Please just wrap my leg back up”. I left and sought care at another clinic after doing extensive research in my city. Even though I live in a major city, proper wound care and wrapping for this condition is lacking, especially at a primary care physicians office. At times myself and many others feel hopeless because of this. Added on to how this condition has destroyed my extremely active lifestyle and ability function on a daily basis is overwhelming. Not being able to get proper care has made it even worse. The Lymphedema Act went into effect of 1/1/2024. Many health care professionals have no idea of the fight to get it introduced and then passed through Congress, or that it even exits. Hopefully it will help us increase awareness and aid in the education of proper wound care and compression bandaging for Venous Insufficiency and Lymphedema.
You should consider removing this video. This is not an appropriate medical application of an unna boot. The ankle isn’t at a 90 degree angle and she argued against folds at the beginning of the wrap which allows for swelling expansion. Is this a community college nursing instructional video ?
Pleating is optional. There is no evidence on pleating- my opinion is that if it increases compression compliance via comfort then proceed. Otherwise non pleated application is the standard. I would guess I apply 20% without pleats and the remainder with pleats based on the patients tolerance of compression.
This was bad teaching and unhelpful “questioning”. Saying oh how beautiful is not helpful or flattering it’s uncomfortable. When the lady did speak she was rambling 100mph and was very unclear about everything.
Rod Rodriguez when your teaching someone how to do something the correct way do u speed through as fast as you can that’s y wound care ends up in court cases 85% of the time because people are doing stuff wrong
@@nonyab5640 Social media is filled with self appointed experts. It's a disinformation plague that is spreading around the world. 'I read / watched it on the internet' is a common sign that someone doesn't know what they are doing.
Pleating is optional and there is no evidence to support. There is however, evidence supporting non pleating ie: therapeutic compression thar is sustained.
I am a patient…. This video should be removed from RU-vid. A similar incorrect wrap was made to my right leg several times by one of the many so called wound care nurses I have encountered over the years. I have venous insufficiency and Lymphedema. It is much worse in my right leg. Many times there is severe wound drainage and severe swelling. This particular incorrectly applied wrap resulted in my requiring to be admitted to the hospital as the too restrictive bandage caused deep cuts to the top of my foot (instep) where it bends for movement. The cuts were all the way to the tendons. I was in the hospital for 7 days and many weeks in a physical therapy center for rehabilitation. There was no dressing applied to my wounds or moisture applied to my severely dry skin. There was no padding applied before the Coban and the Coban was stretched too tightly. My complaints were ignored and the care nurse refused to listen to my concerns or needs and avoided me. After I was admitted to the physical therapy facility, there was no lymphatic followup or massage given to me for either of my legs. It was prescribed by the hospital. My left leg got worse. They refused to give me a moderate compression sock for my left leg. A good portion of the medical community has no idea about Lymphedema or how to apply proper compression bandages, even doctors. I have had so many incidents such as huge blisters developing, terribly restrictive wraps I have had to remove, etc, over the years that led me to ongoing education for myself in proper wound care. I wish I could wrap myself but it is impossible. When I tell the nurse what I need based on years of being a patient they do not listen and get defensive. If a patient is not rich and cannot go to get proper care we are stuck. Instead of getting better over the years my skin has gotten worse. My very dry and venous eczema skin is not cleaned or moisturized prior to bandaging. When I ask that it be done the majority of nurses will not do it or get annoyed when I insist ……. why dont they realize that all that dead skin needs to be removed so my skin can heal properly? When it is done, layers of the skin and dried oozing from the wounds comes off and my skin looks and feels good. When my ulcered legs temporarily heal until the next outbreak, I take care of my skin properly. Then after the next ulcers its back to improper skin care during the wraps. It’s never ending and saddening. The first time, 7 years ago after I was released from the hospital I was referred to an out patient clinic. I was assigned to a young nurse for followup and ongoing wound care as needed. My venous ulcered leg which was still not in very good shape and was healing was unwrapped by the nurse. She went to her cabinet and brought a bottle of peroxide. I asked her what she had and what she was doing and she said she was going to cleanse my leg with the peroxide. I said, ‘No way. Please just wrap my leg back up”. I left and sought care at another clinic after doing extensive research in my city. Even though I live in a major city, proper wound care and wrapping for this condition is lacking, especially at a primary care physicians office. At times myself and many others feel hopeless because of this. Added on to how this condition has destroyed my extremely active lifestyle and ability function on a daily basis is overwhelming. Not being able to get people care has made it even worse. The Lymphedema Act went into effect of 1/1/2024. Many health care professionals have no idea of the fight to get it introduced and then passed through Congress, or that it even exits. Hopefully it will help us increase awareness and aid in the education of proper wound care and compression bandaging,
