Unna’s Boot Dressing Procedure
- Is a commercially prepared, medicated gauze compression dressing that wraps around the foot and leg.
- It can be sued to treat uninfected, non-necrotic leg and foot ulcers caused by venous insufficiency and stasis dermatitis.
- Unna’s paste such as gelatin, zinc oxide, calamine lotion, and glycerin may be applied to the ulcer and covered with lightweight gauze.
- Effectiveness results from compression (bandage) and moisture (paste).
- Allergy to any ingredient
- Arterial ulcer
- Weeping eczema
- Scrub sponge with ordered cleaning agent
- Normal saline solution
- Commercially prepared gauze bandage saturated with Unna’s paste
- Bandage scissors
- Elastic bandage to cover Unna’s boot
- Extra gauze for excessive drainage
- Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
- Reinforce the explanation of the procedure and provide privacy
- Wash your hands and put on gloves
- Monitor the ulcer’s size, drainage, and appearance and the surrounding skin.
- Clean the affected area with the sponge and cleaning agent to retard bacterial growth and remove dirt and wound debris.
- If commercially prepared gauze bandage isn’t ordered, spread Unna’s paste evenly on the leg and foot; cover with the light weight gauze
- Apply three to four layers of paste interspersed with layers of gauze.
- Apply gauze or the prepared bandage in a spiral motion, form just above the toes to the knee.
- Cover the heel, the wrap should be snug not tight.
- Continue wrapping the patient’s leg up to the knee, using firm and even pressure.
- Stop the dressing 1” below the popliteal fossa to prevent irritation when the knee bent.
- Mold the boot with your free hand as you apply the bandage to make it smooth and even.
- Cover the foot with an elastic bandage to provide compression.
- Instruct the patient to remain in bed with his leg outstretched and elevated on a pillow until the paste dries for about 30 minutes.
- Leave the boot on for 5 to 7 days or as ordered.
- Change the boot weekly or as ordered to monitor the underlying skin and ulcer healing.
- Remove the boot by unwrapping the bandage from the knee back to the foot.
- If the boot is applied over a swollen leg, it must be changed as the edema subsides-if necessary, more frequently than every 5 days.
- Don’t make reverse turns while wrapping the bandage. This can create excessive pressure areas that may cause discomfort as the bandage hardens.
- Reinforce the explanation of the procedure to the patient.
- Remind the patient to walk on and handle the wrap carefully to avoid damaging it.
- Remind the patient that the boot will stiffen but won’t be as hard as a cast.
- Remind the patient that before bathing, he should cover the boot with a plastic kitchen trash bag sealed at the knee with an elastic bandage too avoid getting the boot wet.
- Reinforce that he should take a sponge bath if his safety is concern
- Contact dermatitis can occur from application of Unna’s boot.