Actico

• Actico is a a cohesive inelastic compression bandage system
• Simple to apply
• Safe and effective for full leg, below knee and arm bandaging
• Suitable for patients with and without oedema.
• Effective healing for mobile and immobile wearers
• Actico bandage is applied at full stretch onto the limb.
• Non slip so Actico requires fewer re-applications.
• Patients can usually wear their normal footwear.

The results of a randomised trial into the management of chronic venous ulceration have shown that Actico Cohesive, Inelastic Bandage is an effective alternative to four layer bandaging in the management of patients with chronic venous ulceration.

What are Actico bandages?

Actico^® inelastic compression bandages are clinically proven to help your leg ulcer healand/or treat swollen ankles and legs.

The bandages are compression bandages, which means they ‘squeeze’ your limb.

The gentle squeezing pushes the body fluids (either/or blood and lymph) back to where they need to go.

Actico bandages will reduce swollen ankles and legs and help any wound to heal.

Actico^® for legs

• Leg ulcers (a wound on the leg which has not healed after several weeks) are surprisingly common
• Up to 1% of adults in the UK will have one at sometime in their lives
• Swollen legs and ankles are equally common, either with or without a leg ulcer
• The swelling is made up of lymph fluid, which is unable to drain back into the lymphatic system

Actico^® for arms

• Swelling of the arm results from lymph fluid which is unable to drain back into the lymphatic system as well as it should
• Arm lymphoedema affects 1 in 4 people, to different degrees, who have received some form of treatment for breast cancer.
• This is the most common cause of arm swelling, but lymphoedema can result from other types of cancer.
• Lymphoedema can also be a condition you are born with - resulting from defects in the lymphatic system.

What will Actico^® bandages feel like?

They will feel firm, but comfortable.

They will feel firmer when you are up and about, or moving your calf muscle.

They feel less firm when you are lying down or in bed, so that you are able to have a comfortable night’s sleep.

If your entire leg is swollen, the whole leg will be bandaged. This may seem a bit bulky at first, but it is the most effective way of reducing swelling - normally producing fast results.

How long will I need to wear Actico bandages on my leg?

Normally the bandage will be worn for a week at a time until the leg ulcer heals.This usually takes about 3 or 4 months.

If your limb is swollen, Actico^® bandages can reduce swelling very quickly. Therefore your healthcare professional may change your bandages more frequently to start with.

How long will I need to wear Actico^® bandages on my arm?

This varies depending on the amount and nature of the swelling. Your practitioner will advise on this. The bandages are generally used for a short period of time, prior to wearing an ActiLymph^® armsleeve.

Footwear

Providing your normal footwear fits, it is beneficial to keep mobile as this will help your ulcer to heal more quickly.

Remember the importance of elevating your legs when sitting .

Normal shoes may not fit whilst wearing whole leg bandages. Talk to your nurse about this, as obtaining appropriate outdoor shoes will help you to go out and about.

Tips for all Actico^® wearers

• The bandages should not get wet. Waterproof bandage protectors are available and you may wish to discuss this with your practitioner.
• Keep the bandages on. Do not remove or fiddle with them, as this will reduce their effectiveness.
• The bandage should feel firm, but comfortable. If it feels painful or slips down, contact your nurse immediately.
• To assist blood and lymph flow - elevate your affected limb whenever you can, ideally above your heart level.
• Avoid elevating your bandaged arm above heart level for long periods as this may make your shoulder ache.

What next?

Actico^® bandages are the first step to heal any wounds or to reduce swelling. Once this has been achieved to ensure your arm or leg remains healthy, compression garments such as ActiLymph^® are normally worn.

These garments are made from state-of-the-art, lightweight fabrics, with many wearers forgetting they have them on.

Fitting Information

Application for leg ulcer management

Ensure sufficient FlexiBan^® padding is used to protect vulnerable areas and reshape the leg (if necessary) to provide graduated compression. Measure the ankle circumference before and after the padding layer is applied.

Step 1.

Measure the ankle. Reshape/protect the limb (if necessary) by applying FlexiBan^® padding.

Step 2.

Secure padding with two turns at the base of the toes and with a figure of eight at the ankle before using a 50% overlap spiral up the leg to 2cm below the knee/popliteal fossa. Re-measure the ankle.

with an ankle circumference of 18cm-25cm after padding:

Step 3.

Before applying Actico^® 10cm check that the foot is correctly positioned 'toes to nose' to maximise ankle movement. Hold Actico^® with tension and apply two turns from the base of the toes. Roll Actico^® across the dorsum keeping tension. An extra turn may be applied in the middle of a long foot.

Step 4.

Enclose the ankle and heel with a figure of eight.

Step 5.

Start to spiral up the leg using the 'Lock & Roll' method (50% overlap – full stretch). Roll the Actico^® round the back of the leg whilst ensuring it is locked out at full stretch. Continue with the 'Lock & Roll' method up the limb in a spiral.

Step 6.

Finish the Actico^® 3cm below the popliteal fossa. Cut off excess bandage and tape if necessary. Ensure layers are bonded.

with an ankle circumference more than 25cm after padding:

Step 7.

Apply a second Actico^® 10cm in the opposite direction. Secure with two turns with tension over the ankle and on the third turn follow the 'Lock & Roll' method as before in Steps 5 & 6. Finish as before.

Application for chronic oedema and lymphoedema

Step 1.

If necessary bandage the toes using Mollelast^® 4cm retention bandage to prevent swelling in the toes. Pillows can be make to separate skin folds as per the video.

Step 2.

Apply a layer of ActiFast^® tubular retention bandage along the section of the limb being bandaged, allowing an extra 6cm either end.

Step 3.

Assess, reshape and protect the limb using FlexiBan^® padding, ensuring graduated conical shape. Protect the popliteal fossa and make sure the knee has slight flexion. Fold the ActiFast^® over either end of the padding.

Step 4.

Correctly position the foot 'toes to nose' to maximise ankle movement. Apply two turns of Actico^® 8cm starting at the base of the toes and apply with tension. An extra turn may be applied in the middle of a long foot. Bandage the heel with a figure of eight, keeping the tension. Continue a simple spiral (with 50% overlap - full stretch) finishing just above the ankle. Cut off any extra 8cm bandage and secure.

Step 5.

Change to 10cm Actico^® bandage and continue with the 'Lock & Roll' method (50% overlap - full stretch) up the leg.

Below knee: If there is no oedema above the knee - finish the Actico^® bandaging 3cm below the popliteal fossa. Cut off excess bandage. Apply the second layer in the opposite direction repeating from Step 4. Cut off excess bandage and tape if necessary. Ensure layers are bonded.

Step 6.

Full leg: When bandaging above the knee the patient can be sitting or standing, but the knee needs to have slight flexion. Continue to bandage over the knee with the 10cm bandage, changing to 12cm Actico^® above the knee. Continue using the 'Lock & Roll' method, stopping 1cm below the padding. Cut off excess bandage and tape if necessary. Ensure layers are bonded.

Step 7.

Apply a second layer of Actico^®. Follow the same stages from steps 4-6 but apply the second layer in the opposite direction to create a semi-rigid cuff around the limb.

Step 8.

Finish as before.

NB: If patients require support and palliation then one layer may be adequate.

Actico for arms

Actico for arms provides safe and accurate application.

Indications

Actico^® Inelastic Compression bandage system can be used for:

• venous leg ulcers (VLU) with and without chronic oedema
• chronic oedema and lymphoedema
• mobile and immobile patients

ABPI >0.8 - 1.2 Actico^® compression therapy can be applied. If ABPI is >1.2 further investigation is required before Actico^® is applied (please refer to local guidelines).

Precautions

ABPI < 0.8 - Actico^® compression therapy should only be used under strict medical or vascular specialist supervision.

Not suitable for ankle circumference of less than 18cm unless padding is used to increase the ankle circumference to 18cm or more.

As with all compression systems, caution is required when:

• cardiac overload is suspected
• patients have diabetes
• advanced small vessel disease
• arterial disease is present
• renal failure is present

Following application, if the patient shows signs of pain, reduced colour or numbness on their extremities distal to the bandage, then it should be removed immediately.

Actico^® should not be re-used. As with all compression bandage systems, training on the correct application of Actico^® is recommended. Actico^® contains low sensitivity latex.

If latex intolerance is suspected, the use of Rosidal^® K 100% cotton inelastic bandage is recommended.