Unna Boot Procedures

The Unna boot, named for its creator, Dr. Paul Gerson Unna, is used to treat venous ulcers resulting from pooling blood in the legs. A mixture of emollients and antibacterial agents are used to promote healing of the ulcer while protecting it from infection.

Determining Need for an Unna Boot

• If the valves in the lower legs do not close properly, blood can pool in the area. This causes the veins to stretch and creates swelling in the legs. The increased pressure in the lower leg and breakdown of the veins damages the surrounding tissue. The skin becomes weak and can split or be easily cut, which results in a venous ulcer at the site where the skin has been compromised.

  First, your doctor may perform tests to indicate the severity of the problem. These tests include photoplethysmography (PPG) which measures how well the artery valves are working in the legs, and a venous flow study, which shows blockages in the deep veins and detects how well blood returns to the heart. While minimally invasive procedures such as the use of an Unna boot are typically attempted first, a doctor may find surgery necessary later.

Unna Boot Procedure

• The Unna boot is made up of a gauze strip about 4 inches wide and about 10 yards long. The bandage is layered with zinc oxide, calamine lotion and glycerin which soothe, heal, and prevent infection of the ulcered site.

  Typically, the gauze boot wraps from the patient's toes to just below the knee. The gauze and protective salves cover the ulcer and the entire lower leg region. After the gauze dries and hardens thoroughly, an elastic bandage is wrapped firmly over the hardened gauze.

  The physician will determine how often to put on a new Unna boot. Typically, a new boot is created every one to two weeks until the ulcer heals fully. Changes may be necessary more frequently for heavily draining ulcers.

  Larger venous ulcers take longer to heal, sometimes up to several months. Smaller ulcers can heal in as little as a few weeks.

Care of the Unna Boot

• Patients must keep the Unna boot dry. They should not bathe or take a standing shower while wearing an Unna boot. If absolutely necessary, the Unna boot may be covered with plastic and secured with bandages to prevent wetting the boot. Sponge bathing is acceptable for those who wear an Unna boot.

  Patients can normally wear a sock and regular footwear covering an Unna boot.

  The leg should be monitored for swelling, abnormal pain and other signs of infection. A doctor will be able to tell what is normal and what needs immediate care in these situations.