Hartmann FourPress Compression Bandaging System is an expertly designed solution, tailor-made to manage venous leg ulcers by providing consistent and effective compression. This advanced system is made up of four carefully structured layers: a soft padding layer, a supportive crepe layer, a firm compression layer, and a secure cohesive bandage layer. The collaboration of these layers delivers sustained compression, maintaining sub-bandage pressure at the crucial 30 to 40mmHg range for up to seven days when applied as indicated.

Features:

• Optimal compression and absorbency for venous leg ulcer management
• Multi-layer system including padding, crepe, compression, and cohesive bandages
• Designed for sustained compression up to seven days
• Layer 1 provides a comfortable nonwoven padding that absorbs exudate
• Layer 2, the crepe bandage, anchors the system and continues absorption
• Layer 3 delivers about half the system's compression while conforming to body contours
• Layer 4's cohesive properties keep the system intact without the need for additional tape
• Latex-free composition, minimizing allergic reactions

Indications:

The FourPress Compression Bandaging System is indicated for the management of venous leg ulcers and related conditions. The system consists of four latex-free bandages that, when applied as directed, provide compression for seven days. The subbandage pressure at the ankle (21 cm circumference) will be in the 30-40 mmHg range. Sub-bandage pressures will be slightly higher when applied to an ankle with a smaller circumference and will be slightly lower when applied to larger than 21 cm circumference ankles.

Contra-Indications: Determine the Ankle Brachia Pressure Index (ABPI) using a Doppler ultrasound. An ABPI less than 0.8 indicates the presence of arterial disease. Do not apply the Bandaging System if the patient's ABPI is less than 0.8 or if arterial disease is suspected.

How to apply:

Before applying the first bandage:

1. Check the ABPI (Ankle Brachial Pressure Index) to determine if arterial disease is present. If the ABPI is less than 0.8 do not apply the FourPress.
2. Measure the ankle circumference. If ankle circumference is less than 18 cm (7 1/8"), pad the ankle and bony prominences completely to protect against excessive sub-bandage compression which can cause tissue necrosis. Urge the patient to seek medical attention if numbness or pain in the toes or feet occurs and/or if the bandages become uncomfortable or irritating.
3. Apply an appropriate non-adhesive primary dressing to cleansed wound before applying FourPress.

Layer One - Padding Bandage:

1. In a spiral fashion, wrap the padding bandage from the base of the toes up the leg to just below the knee.
2. Cut or tear off any excess padding.
3. Use any excess to pad bony prominences such as the tibial crest.
4. This is especially important when the leg is thin and bony.
5. While wrapping, overlap each layer of the bandage by one-half the width.
6. Smooth after each turn.
7. To hold the bandage in place, secure the end with one of the three strips of tape supplied in the kit.
8. When applying a compression system to the leg, it is important to enclose the heel with all layers of the System.

Layer Two - Crepe Bandage:

1. Use the same spiral bandaging technique as for layer one.
2. Wrap the bandage from the base of the toes up the leg to just below the knee.
3. While wrapping, overlap each layer of the bandage by one-half the width.
4. Smooth after each turn.
5. To hold the bandage in place, secure the end with the second of the three strips of tape.

Layer Three - Compression Bandage:

1. Using a Figure 8 bandaging technique, wrap the bandage from the base of the toes to just below the knee.
2. Use the yellow line as a guide to determine one-half of the width of the bandage.
3. While wrapping, stretch the bandage to 50% of its relaxed length.
4. At the base of the knee, cut off any excess bandage and secure the end with the third tape strip.

Layer Four - Cohesive Bandage:

1. Caution: As you unroll the cohesive bandage, be sure to unroll enough of the bandage (e.g., 18"-24") from the roll to complete one full turn around the leg. Allow the unrolled portion to relax then stretch it 50% and apply it around the leg. Unroll another 18"-24" and repeat the relaxing, stretching and applying sequence until you have wrapped to just below the knee.
2. Wrap the bandage in a spiral manner from the base of the toes up the leg to just below the knee.
3. Stretch the bandage to 50% of its relaxed length.
4. Overlap each layer of the bandage by one-half the width.
5. At the base of the knee, tear or cut off any excess bandage.
6. The cohesive bandage will adhere to itself securing all the bandages in place.
7. To ensure that the cohesive bandage adheres firmly, let the last 6" to 8" of the bandage relax before adhering it to the underlying layer.
8. Mold and squeeze the bandaged leg to increase the cohesiveness of the outer layer.