PROFORE 4 CO-PLUS

CRITICAL SAFETY NOTICE: Compression bandaging systems are contraindicated in peripheral arterial disease. An ankle brachial pressure index (ABPI) assessment must be performed and documented before any compression bandaging system is applied. Profore 4 Co-Plus must only be applied as part of a multilayer compression system by a trained healthcare professional. It is not for patient self-application.

The outer layer of a multilayer compression system has two roles: to deliver the primary therapeutic compression and to hold all the layers beneath it firmly in position throughout the wear period. A cohesive bandage achieves both. It bonds to itself on contact, removing the need for clips, pins, or additional fixation, and its self-adherent surface keeps all the underlying layers firmly in place between clinical visits. Profore 4 Co-Plus is a cohesive compression bandage from Smith & Nephew for use as the outer compression layer in multilayer compression systems for venous leg ulcer management. 10cm x 3.5m. Clinical application only. No prescription required.

Profore 4 Co-Plus is a regulated medical device from Smith & Nephew. It is a cohesive elastic compression bandage designed for use as the outer compression layer in a multilayer bandage system for venous leg ulcer management. The defining property of a cohesive bandage is its self-adherent surface: the bandage sticks to itself when the layers make contact during application but does not adhere to skin or clothing. This cohesive property holds the bandage in position throughout the wear period without clips, pins, or other fixation devices.

The bandage is elastic. When applied with consistent tension in a spiral technique from the foot to the knee, it generates compression against the underlying limb. The compression acts through all the layers beneath to reduce the venous hypertension in the superficial venous system that drives venous leg ulcer formation and impairs healing. The total compression delivered at the ankle depends on the tension applied during bandaging and the contribution from each layer of the system beneath.

Co-Plus is positioned as layer four in the Profore multilayer system, the outermost compression layer applied over the padding and conforming layers below. The cohesive outer surface of Co-Plus also holds all the underlying layers of the system together. This containment function is clinically important: it prevents the padding and conforming layers from slipping, bunching, or separating during normal daily activity between dressing changes.

Profore 4 Co-Plus is supplied in a single size of 10cm x 3.5m. The 3.5m length provides sufficient bandage to apply a spiral compression layer from the foot to the knee with consistent overlap in a standard adult application.

Arterial disease must be excluded before the compression system is applied. An ABPI of 0.8 or above is generally required for full high compression. ABPI between 0.6 and 0.8 may permit reduced compression under specialist supervision. ABPI below 0.6 is a contraindication to compression bandaging. Any patient with symptoms of arterial insufficiency requires ABPI assessment before compression is considered.

Cohesive and Self-Adherent Property

The surface of Co-Plus is coated with a cohesive agent that causes the bandage to bond to itself on contact. When the bandage is applied in overlapping spirals up the limb, each turn bonds to the turn below it on contact. This creates a unified outer layer that does not slip or unravel during wear. The cohesive surface does not adhere to the skin beneath the bandage or to clothing in contact with the outer surface. This makes Co-Plus comfortable to wear and allows the outer layer to be removed cleanly at dressing changes without adhesive trauma to the skin.

Elastic Compression

The elastic construction of Co-Plus allows it to generate compression when applied under tension. Applied with consistent stretch in a spiral technique, the elastic recoil of the bandage exerts inward pressure against the lower limb. This compression, applied over the underlying layers from the foot to below the knee, reduces the calibre of the superficial venous system and counteracts the raised venous pressure that impairs healing in venous leg ulcers. The compression level depends on the tension applied and the method of application.

Containment of Underlying Layers

As the outermost layer, Co-Plus contains and stabilises all the layers beneath it. The cohesive surface bonds to the outer surface of the layer below on every turn, holding the entire bandage system together. This containment function reduces the risk of individual layers slipping, rotating, or bunching during daily activity. A system that remains in the correct position throughout the wear period delivers more consistent compression than one that shifts between applications.

Applied as Part of the System

The compression and clinical outcomes associated with multilayer systems are based on the validated combination of layers applied in the correct sequence. Co-Plus, as the outer layer, contributes its compression and containment function to the total system. It is applied after the wound contact, padding, and conforming layers are already in place. The total compression at the ankle is the cumulative result of all layers, and Co-Plus contributes the largest share of this as the primary compression layer.

Who Applies Profore 4 Co-Plus

• Applied by trained healthcare professionals only.
• Appropriate applicators include district nurses, tissue viability nurses, and community nurses trained in multilayer compression bandaging.
• ABPI must be completed and documented before the first application.

Application within the Multilayer System

• Apply all underlying layers (wound contact, padding, conforming) before Co-Plus.
• Apply Co-Plus in a spiral technique from the base of the toes upward to below the knee.
• Apply with consistent tension and 50% overlap between turns.
• The cohesive surface will bond each turn to the one below without clips or pins.
• Do not apply under excessive stretch. Apply at the tension consistent with the compression target for the system.

After Application

• Check patient comfort after the system is complete.
• Confirm no signs of arterial compromise are present.
• If pain, cold toes, numbness, or colour change develops, remove all layers immediately.

If the patient reports pain, increasing discomfort, cold feet, numbness, tingling, or colour change in the toes after application, remove all bandage layers immediately and reassess the limb. Do not reapply compression until the cause has been identified and arterial disease excluded.

Profore 4 Co-Plus 10cm x 3.5m

Supplied as a single 10cm wide, 3.5m length cohesive elastic bandage. The 3.5m length provides sufficient material for a spiral application from the foot to below the knee with consistent overlap in a standard adult lower limb. The cohesive surface is on the outer face of the roll and activates on contact with the previous turn during application.

Contraindications

• Peripheral arterial disease with ABPI below 0.6.
• Confirmed limb ischaemia.
• Severe uncontrolled cardiac failure.

Cautions

• ABPI between 0.6 and 0.8: reduced compression under specialist supervision only.
• Peripheral neuropathy: reduced sensation impairs the patient's ability to report compression pain.
• Diabetes with vascular complications.

Warning Signs After Application

• Pain or tightness in the bandaged limb.
• Cold toes or pallor of the digits.
• Numbness or tingling in the foot.
• Any of these requires immediate removal of all layers and clinical reassessment.

Cohesive Bandage Specific Note

• Do not apply excessive tension. Cohesive bandages can be applied more tightly than standard elastic bandages because the self-adherent surface maintains position without slipping. Excessive tension increases compression above the therapeutic range.

Clinical Use as the Outer Compression Layer

Profore 4 Co-Plus is used as the outermost compression layer in a multilayer compression bandage system for venous leg ulcer management. It is not a standalone compression bandage for independent use. The compression and clinical outcomes associated with multilayer systems are based on the validated combination of all layers applied in the correct sequence. Co-Plus provides the outer compression and containment function within this validated system.

Co-Plus vs Profore+ as Outer Compression Layer

Both Co-Plus and Profore+ are Smith & Nephew outer compression bandages used in multilayer compression systems. The key difference is the outer surface. Profore+ is a standard elastic bandage that requires the final turns to be secured by tucking or with a clip. Co-Plus is a cohesive bandage that bonds to itself and requires no additional fixation. Cohesive bandages offer the practical advantage of not requiring clips and are less likely to unravel during wear. Selection between the two is based on the specific system protocol and clinician preference.

Profore 4 Co-Plus is a regulated medical device and does not require a prescription. The 10cm x 3.5m bandage is available from Pharmacy Planet for clinical purchasers.

Our pharmacists can advise on Co-Plus and on other compression system components from the Smith & Nephew range.

This is a clinical product for use as part of a multilayer compression system by trained healthcare professionals. ABPI assessment must precede use.

• Store in a cool, dry place away from direct heat and sunlight.
• Do not store above 25 degrees C.
• Keep in original sealed packaging until use.
• Check expiry date before use.
• Keep out of reach of children.

Pharmacy Planet is a GPhC registered online pharmacy. Profore 4 Co-Plus is a genuine Smith & Nephew product stocked through regulated UK supply chains.

Our pharmacists can advise on compression system components and on the full range of compression bandaging products from Smith & Nephew.

References

1. Smith & Nephew. Co-Plus Cohesive Bandage — Product Information. Smith & Nephew. https://www.smith-nephew.com. Accessed June 2026.
2. National Institute for Health and Care Excellence. Chronic wounds: advanced wound dressings and antimicrobial dressings. NICE Evidence Review. https://www.nice.org.uk. Accessed June 2026.
3. NHS. Venous leg ulcer: treatment and compression therapy. https://www.nhs.uk/conditions/leg-ulcer. Accessed June 2026.
4. Wounds UK. Best Practice Statement: Compression hosiery. https://www.wounds-uk.com. Accessed June 2026.