What is a 4-layer compression boot?
A 4-layer compression boot is used to care for leg ulcers caused by venous hypertension. This 4-layer boot pads bony bumps, absorbs wound drainage, and helps to decrease swelling in the leg. This boot may be left on for up to 7 days.
How is the boot put on?
Your leg and wound will be washed before putting on the 4-layer compression boot. A topical antibiotic and/or a dressing may be put on over the wound before the boot is applied. The boot will be put on in 4 layers, starting with a padding bandage.
Layer #1 protects bony bumps, absorbs wound drainage, and helps to shift pressure evenly around the leg.
Layer #2 is fine mesh gauze with calamine layer which absorbs drainage and smoothes out the first layer and prevents the boot from slipping down when moving.
Layer #3 is a compression bandage. It conforms well to the leg and must be applied in a figure-8 pattern.
Layer #4 is a cohesive compression bandage that places pressure on the wound and holds the 4-layer system in place until it is changed.
How do I care for the compression boot?
Watch the toes for change in color (blue, darkening, or white), temperature (cold), swelling, or numbness. Call if any of these symptoms continue.
Keep the leg raised above the level of your heart when sitting or lying down if you can. Do not sit with leg at a 90° angle as this affects the blood supply to your legs.
Keep the boot dry. Sponge bathe or cover boot with a heavy plastic bag secured with tape above the boot when taking a shower. Keep the leg out of the tub if bathing.
Walk as advised by your health care provider. You may need to get a slipper or shoe 1-2 sizes larger to cover your foot.
Do not put any object into the boot if the leg itches.
Call the clinic if your boot slides or shifts down your leg.
For questions or concerns about this 4-layer boot, call the Burn/Wound Clinic at
If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.