PROFORE +

CRITICAL SAFETY NOTICE: High compression bandaging is contraindicated in patients with peripheral arterial disease or mixed aetiology leg ulcers where the arterial component has not been excluded. Applying high compression to a limb with significant arterial disease can cause limb ischaemia and permanent damage. An ankle brachial pressure index (ABPI) assessment must be performed and documented before Profore+ or any high compression bandage system is applied. Profore+ must only be applied by a trained healthcare professional. It is not for patient self-application.

Venous leg ulcers are among the most common chronic wounds managed in the community. Reducing the venous hypertension that drives venous leg ulcer formation is the clinical foundation of management, and sustained graduated compression is the established method. A multilayer compression system applies compression through the leg from the foot to the knee using multiple bandage layers, each contributing to the total compression delivered at the ankle. Profore+ is a multilayer high compression bandage system from Smith & Nephew for venous leg ulcer management. Two variants: Tensopress and Latex Free. Both 10cm x 3m. Clinical application by trained professionals only.

Profore+ is a regulated medical device from Smith & Nephew. It is part of the Profore multilayer high compression bandage system, which is one of the established compression systems for venous leg ulcer management in the UK community nursing practice. The Profore system consists of four layers applied sequentially over the limb from the foot to the knee, each serving a distinct function in the overall compression system.

Profore+ refers to the compression component of the system. It is available in two variants: the Tensopress version, which uses an elastic compression bandage, and the Latex Free version, which provides the same compression function without latex for patients with latex sensitivity or allergy. Both variants are 10cm wide and 3m in length. The bandage is the outer compression layer within the multilayer system.

Multilayer compression for venous leg ulcer management is supported by NICE guidance and NHS clinical practice. The sustained graduated compression generated by the system reduces venous hypertension in the lower limb. By counteracting the raised venous pressure in the superficial venous system, compression reduces oedema, promotes healing of the ulcer wound bed, and reduces the likelihood of ulcer recurrence when maintained.

Profore+ is a clinical product. It is purchased by district nursing teams, tissue viability services, community nursing practices, and other clinical settings where venous leg ulcer management with compression is provided.

Arterial disease must be excluded before application. An ABPI of 0.8 or above is generally required before full high compression can be applied. An ABPI between 0.6 and 0.8 may permit reduced compression under specialist supervision. An ABPI below 0.6 is a contraindication to compression bandaging. Any patient with symptoms of arterial insufficiency, claudication, rest pain, or cold feet should have ABPI measured before compression is considered.

The Multilayer Compression Principle

Graduated compression works by applying the highest pressure at the ankle, with pressure reducing progressively as the bandage is applied up the limb toward the knee. This pressure gradient mimics and supports the action of the calf muscle pump, which drives blood from the deep veins of the lower leg upward toward the heart during walking. In venous hypertension, the valves of the perforating veins are incompetent and venous blood pools in the superficial system. Sustained graduated compression applies external pressure that reduces the superficial venous blood pool and counteracts the raised pressure.

Layer Function in the Profore System

The Profore system applies compression across four layers, each serving a purpose. A wound contact layer is applied directly over the ulcer. An absorbent padding layer distributes the compression evenly over the contours of the lower limb, protects bony prominences, and absorbs wound exudate. A light conforming bandage holds the padding in place. The outer compression bandage, to which Profore+ belongs, applies the therapeutic compression. The compression generated by the outer bandage acts through all the underlying layers to deliver sustained graduated compression at the ulcer site.

Tensopress vs Latex Free Variant

The Tensopress variant uses an elastic bandage construction to deliver compression. The Latex Free variant provides the same compression function using materials that do not contain latex, making it appropriate for patients with latex allergy or sensitivity. Both deliver the same clinical compression when applied as part of the Profore system. The variant selected depends on the patient's latex sensitivity status as assessed before application.

Wound Healing Under Compression

Venous leg ulcers heal under sustained compression when the underlying venous hypertension is adequately controlled and the wound contact environment supports healing. The compression layer contributes to this by reducing lower limb oedema, improving microcirculation in the ulcer bed, and reducing exudate volume as the oedema resolves. Healing rates under sustained multilayer compression are supported by clinical evidence, as referenced in NICE guidance for venous leg ulcer management.

Who Applies Profore+

• Profore+ is applied by trained healthcare professionals only.
• Appropriate applicators include district nurses, tissue viability nurses, community nurses, and other clinicians trained in multilayer compression bandaging.
• ABPI assessment must be completed and documented before the first application.
• Reassessment is needed if the patient reports new symptoms of arterial insufficiency at any subsequent visit.

Application Guidance

• Apply the wound contact layer and padding layers before the compression layer.
• Begin the compression bandage at the base of the toes and apply with a spiral technique up the limb.
• Apply at full stretch with 50% overlap between turns to achieve the intended compression.
• Finish below the knee.
• Check patient comfort and limb perfusion after application.

Change Interval

• The Profore system is typically changed weekly or as clinically indicated by wound status and oedema level.
• Remove the system if the patient reports pain, increased discomfort, or any sign of arterial compromise after application.

If the patient reports pain, cold feet, numbness, or colour change in the toes after compression bandage application, remove the bandage immediately and reassess arterial status. These are signs that compression may be causing ischaemia. Do not reapply compression until arterial disease has been formally excluded.

Profore+ 10cm x 3m: Tensopress

The Tensopress variant is the standard elastic compression bandage within the Profore system. 10cm wide, 3m unstretched length. Applied at full stretch as the outer compression layer in the four-layer system. Suited to patients who have been confirmed latex-tolerant.

Profore+ 10cm x 3m: Latex Free

The Latex Free variant provides the same compression function without latex-containing materials. 10cm wide, 3m unstretched length. Applied identically to the Tensopress variant as the outer compression layer. Suited to patients with confirmed or suspected latex allergy or sensitivity.

Both variants are used within the same Profore four-layer application protocol.

Absolute Contraindications

• Peripheral arterial disease with ABPI below 0.6.
• Confirmed limb ischaemia.
• Uncontrolled cardiac failure with severe oedema.
• Severe phlebitis or cellulitis without clinical guidance.

Relative Contraindications and Cautions

• ABPI between 0.6 and 0.8. Reduced compression may be applied under specialist supervision only.
• Diabetes with peripheral neuropathy. Reduced sensation means the patient cannot reliably report pain from ischaemia.
• Latex allergy. Use the Latex Free variant.
• Rheumatoid arthritis affecting the lower limb.

Warning Signs After Application

• Pain, tightness, or increased discomfort in the bandaged limb.
• Cold toes or pallor of the digits.
• Numbness or tingling in the foot.
• Any of these signs requires immediate bandage removal and clinical reassessment.

Patients Where Profore+ Is Appropriate

• Adults with venous leg ulcers confirmed as venous in aetiology or mixed with adequate ABPI to tolerate high compression
• Patients with oedema and venous insufficiency where compression therapy has been prescribed by the clinical team
• Clinical settings with trained compression competent staff

Compression Therapy in Context

Multilayer high compression bandaging for venous leg ulcers is recommended in NICE guidance and NHS clinical pathways as the standard of care where arterial disease has been excluded. The Profore system is one of the established multilayer systems in UK community nursing practice. The decision to commence compression therapy, select the compression system, and determine the change interval is made by the clinical team managing the patient, not the patient independently.

Profore+ is a regulated medical device and does not require a prescription. Both variants are available from Pharmacy Planet for clinical purchasers.

Our pharmacists can advise on the Profore system components and on ordering for clinical settings.

Profore+ is a clinical product for use by trained healthcare professionals in settings where compression bandaging is provided under clinical supervision. 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. Both Profore+ variants are genuine Smith & Nephew products stocked through regulated UK supply chains.

Our pharmacists can advise on Profore system components and on other compression therapy products available from the Smith & Nephew range.

References

1. Smith & Nephew. Profore Multilayer Compression Bandaging System — 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.