Wounds International Vol 2 Issue 1Made Easys3M™ COBAN™ 2 Compression made easy

3M™ COBAN™ 2 Compression made easy

01/02/11 | Complex wounds, Leg ulcers, Lymphoedema | Vowden K, Vowden P, Partsch H, Treadwell T

3M™ COBAN™ 2 Compression made easyThe 3M Coban 2 Compression System is designed to address some of the problems that may be associated with multi-component compression systems, eg two- or four-layer bandaging, or compression hosiery. This system has two layers, is quick and easy to apply [1] and produces effective, consistent pressure that effectively manages oedema [2-4]. The 3M™ Coban™ 2 Compression System also demonstrates reduced slippage[5] and is suitable for a wide range of patients [6]. This article describes why, when and how to effectively and safely use this system.

Challenges associated with compression therapy
When compression therapy is indicated, clinicians need to ensure that it is applied in a way that will safely deliver sufficient pressure to reduce oedema without causing pressure damage [7]. Clinicians need to be knowledgeable of the features of the different bandage systems and their appropriate use. In addition, they require training and should have demonstrated competency in the bandage application technique for the system in use [8].

Non-compliance
Non-compliance with compression therapy in patients with venous leg ulceration is a recurring problem [9]. In a study of 150 patients with venous insufficiency, less than half of patients reported full compliance with compression therapy [10]. A recent review found that poor concordance with compression therapy reduces venous leg ulcer healing rate, doubling the time to complete healing [11]. A wide variety of physical and psychosocial factors have been identified as contributing to non-compliance [12,13]. For example, patients may choose to remove the bandages if they are associated with pain, make the patient feel too hot, slip down, or are too bulky to wear with the patient’s usual shoes or clothes12. Removal of the bandages may result in an interruption to therapy, and has the potential to delay wound healing.

What are the properties of the ideal compression system?
The ideal compression system enables clinicians to deliver effective compression with a low complication rate (Box 1).

Box 1

What is the 3M™ Coban™ 2 Compression System?
The 3M™ Coban™ 2 Compression System is a two-layer compression bandage system that is easier to apply and less bulky than traditional four-layer bandage systems. There are two forms of the system: 3M™ Coban™ 2 and 3M™ Coban™ 2 Lite.

The inner latex-free foam sheet of both products is identical. It has a cohesive backing, is applied foam side to the skin and is highly conformable, ie will mould to the shape of the leg easily. The cohesive backing has adhesive properties that enable it to attach to the outer layer of the compression system across its whole surface to form a stable, effective compression system.

The outer layer is a short stretch cohesive bandage that is applied over the inner layer to provide compression. It interlocks with the inner layer creating an inelastic bandage system that is less likely to slip down the leg during wear. The outer layer of 3M™ Coban™ 2 Lite is different in appearance to that of 3M™ Coban™ 2, and allows lower resting pressures, but similar working pressures to 3M™ Coban™ 2.

Part of the inspiration for designing the 3M™ Coban™ 2 Compression System to be inelastic came from examining the properties of giraffe skin. It is known that the fibrous, inelastic skin of giraffes helps to explain why they do not experience skin changes as a result of venous hypertension [15].

Clinical evidence for the 3M™ Coban™ 2 Compression System
Compression therapy is considered the gold standard of care for treating venous hypertension and venous ulceration [16]. A Cochrane review of compression therapy for venous leg ulcers concluded that venous ulcers heal more rapidly when compression is used than when it is not17. Box 2 details the mechanisms of action of compression therapy in reducing oedema and aiding healing of venous leg ulceration.

Box 2

The studies demonstrating the effectiveness and patient acceptability of the 3M™ Coban™ 2 Compression System are summarised in Table 1.

These studies have

  • demonstrated that 3M™ Coban™ 2 Compression System:
  • provides effective, therapeutic compression for the treatment of venous leg ulcers [4, 24-25]
  • has reduced slippage [5]
  • improves health-related quality of life [5]
  • is safe, well-tolerated and comfortable [2,5], and preferred by patients in comparison with a four-layer system [5].