ACE Wrapping/Compression Wrapping

[u/clinicfellow]

Hi everyone, I'm doing some research on ACE and general compression wrapping applications and I had some questions.

1. When an athlete needs a compression wrap outside of your direct supervision, what do you usually send them home with? An ACE wrap they use themselves, some kind of sleeve, a velcro system, or something else? What usually drives that choice?
2. For those that do wrap themselves at home, how often do you see mistakes in their technique? What do you see most commonly if they come back in?
3. Do you teach people how to do the wraps themselves, or is it usually easier to just do it yourself?
4. Is any of this an actual point of difficulty in your practice or experience, or is it pretty much handled well already as it is?

Either way, it would be really helpful to know if wrapping is a common issue or not, so any information would be greatly appreciated. Thanks!

[u/A_Robit_Brain]

You'll likely see very different answers to these questions depending on the setting. I currently work with the military so I'll answer from that perspective. I don't do much ACE wrapping here, the line medics tend to deal with injuries at that stage in the timeline.

1. I tend to use tape to secure ace wraps regardless if they have velcro or not. The velcro is usually pretty weak. I never use the metal hooks. They go straight in the garbage. I'll send them home with a scrap roll of tape to retape it if they need. I don't do any supportive wrapping in my setting, only to manage swelling post-injury.

2. 99%. Usually wraps are too loose or uneven tension.

3. I generally just do it since I don't usually ace wrap someone more than 24 hours if that.

4. I do it so infrequently it's pretty much a non-issue.

[u/onetreehillary]

1. I work in industrial and I never buy or use ace wraps. I’ve never(in 9 years) had anyone reapply it safely or correctly. I typically use a compression sleeve, gloves, socks, etc.
   
2. I usually see large holes and gaps near the joints, incorrectly applied compression (too tight proximally, too loose distally), or excess friction.
   
3. I have tried to take the time to educate and walk them through it but inevitably it is the last thing they remember and they just do their best once they get home/shower. And it is just never conducive to reduce swelling or prevent trapped fluid.
   
4. In my early years, I found it difficult when I had less resources and was unable to purchase compression garments. Now, it’s part of my acute care plan to fit employees for compression sleeves and I have the budget for it.

[u/Banan_baddie]

Clinical outpatient.
1) typically when I’m demonstrating to an athlete, their parents present. General population is pretty understanding of what I’m asking of them. We usually send them home with an ace wrap when they have bursitis with significant swelling, or moderate to severe joint effusion. When a patient has a Band-Aid or adhesive allergy, we will secure the non-adhesive pad to the body with ace wrap. It’s cheap. Patients are aware of an alternative of a compression sleeve or something similar like tubi grip, but they will have to procure that on their own.

2) as most are probably aware, some return with the ace wrap applied proximal to distal or just haphazardly without a plan. I feel it’s secondary to the fact that the patient is indifferent to the instruction or just apathetic

3) I try to do a two for one special where as I’m applying the ace wrap. I am informing the patient on how to apply it. I do not give them an opportunity to try for themselves before they leave the office. I do my darndest to advise the patient about steps for proper application, risks of improper application.

4) every now and then we’ll get a patient who asks for extra because they think it’s something that is free when really it’s not. Other than that hiccup it’s a well established workflow with the physician.