Hi Melissa,

Compression bandage slippage can occur due to several factors including:

• Reduction in limb size: As edema decreases, the limb size reduces, requiring more frequent bandage changes until the limb size stabilizes.
• Incorrect bandage application: Improper application can lead to slippage.
• Abnormal limb shape: Applying compression bandage around an irregularly shaped limb without padding to approximate a normal shape can cause the bandage to slip.

Slippage can lead to discomfort, pain, skin trauma, new ulcers, and decreased patient adherence. Additionally, excessive pressure from a slipping bandage can create a tourniquet effect, increasing the risk of tissue ischemia.

If slippage occurs, the bandage should be removed and reapplied immediately, or a different bandage should be applied. When first applying a compression bandage, it may need to be reapplied every 2-3 days, especially during the first 1-2 weeks as the edema decreases.

Colleagues might have other tips to minimize slippage in evenly shaped legs but here are some thoughts in addition to the above:

• Ensure excess exudate is well managed

• Use self-adherent bandages: Self-adherent bandages, which stick to themselves without the need for pins, clips, or tape (e.g., K2 venous compression wraps, Coban 2), can help prevent slippage.

• Ensure proper technique:

  • Overlap: Make sure bandage overlap is correct upon application
  • Bandage tension: Apply the bandage with consistent tension - too loose, and it will slip; too tight, and it may cause discomfort or restrict circulation. The tension should be just enough to secure the dressing without slipping.

• Monitor bony prominences if slippage is a concern.

  Additional reading:

  https://woundreference.com/app/topic?id=how-to-select-compression-therapy#troubleshooting-adverse-effects

  https://www.hmpgloballearningnetwork.com/node/210036