This form of compression is also called the Unna boot. Unna boots contain topical medication and need to be applied in layers by trained personnel. The bandage becomes stiff after drying, which helps to prevent edema. The bandages are changed once weekly or even sooner. Unna boots are easier to put on than elastic compression stockings and may produce faster healing of venous ulcers. However, they are uncomfortable to wear.

Additional forms of elastic compression include simple elastic wraps and multilayered wrapped dressings. A four-layered elastic compression bandage may produce better absorption and compression strength compared with simple wraps (Figure 3). This bandage may be used for people whose ulceration does not improve with other methods.

Another wrap, the legging orthosis, consists of many adjustable compression bands held in place with Velcro tape (Figure 4). The orthosis provides firm compression that is similar to that of the Unna boot. It may be used for people who cannot or will not wear compression stockings.

Figure 3

Figure 4

Figure 3. Four-layered bandage for better absorption and compression.
(From Gloviczki P, Yao, JST, eds. Handbook of Venous Disorders, 2nd ed. London: Arnold, 2001:307, Fig. 30.3)

Figure 4. Legging orthosis.
(Awaiting permission from Nehler MR, Moneta GL, Chitwood RW, Porter JM. The lower extremity venous system. Part III: Nonoperative treatment of chronic venous insufficiency. In Goldstone J, ed. Perspectives in Vascular Surgery, vol. 5. St. Louis: Quality Medical Publishing, 1992:100-113.)