Bob VogelQ. A friend of a friend who is a T6 para gets swelling in her lower legs. Somehow she developed a sore on the outside of her lower right calf, but she doesn’t remember any pressure or trauma to the area.  The sore wouldn’t heal even though she spent months with it elevated.  She finally went to a wound care clinic and they put something called an Unna Boot on her lower leg — it looks sort of like a soft cast. This enabled her to spend time upright in her chair while still taking breaks to elevate her leg. Amazingly, the entire wound healed in about one and a half months! What exactly is an Unna Boot? And how does it help heal so fast?
— Stacy

A. Stacy, your friend’s story is a good reminder that when any type of skin breakdown or burn doesn’t heal right away, it’s time to visit a doctor to get a referral to a wound care clinic. It is important to understand that different types of sores (also known as skin ulcers) require different treatments. Also, different stages of healing require different treatments. Clinicians at a wound care clinic have the specialized training to address this and give you the best shot at healing as quickly as possible.

To explain how an Unna boot works, it is important to understand what it is used to treat. Dr. Bruce Ruben, founder of Encompass Healthcare, a state-of-the-art wound care clinic in West Bloomfield, Mich. (see “New Model for Wound Care,” NM April 2013) explains that there are five main reasons why a wound doesn’t heal:

• Pressure

• Infection

• Impaired circulation

• Poor nutrition

• Edema

The main healing problem an Unna Boot addresses is edema (swelling due to blood and fluid pooling in lower extremities). The “boot” is a type of compression wrapping for treati