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Compression for preventing recurrence of venous ulcers.
E A Nelson1, S E Bell-Syer, N A Cullum
1Centre for Evidence Based Nursing, Department of Health Studies, University of York, Genesis 6, York, YO10 5DQ, UK, YO10 5DQ. ean2@york.ac.uk
The Cochrane Database of Systematic Reviews
|October 18, 2000
Summary
Compression hosiery may help prevent venous leg ulcer recurrence. Patients should use the strongest compression they can tolerate, as not wearing compression is linked to higher recurrence rates.
Area of Science:
- Vascular Medicine
- Dermatology
- Wound Care
Background:
- Venous leg ulcers affect up to 1% of adults, primarily caused by venous hypertension.
- Compression therapy is the mainstay for healing and preventing recurrence of venous leg ulcers.
Purpose of the Study:
- To evaluate the efficacy of compression hosiery or bandages in preventing venous leg ulcer recurrence.
- To identify optimal compression pressure and type for recurrence prevention.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through extensive database searches up to June 2000.
- Independent data extraction and quality assessment by two reviewers.
Main Results:
- No RCTs directly compared compression versus no compression for ulcer recurrence prevention.
- One trial showed no significant difference in recurrence between high (UK Class 3) and moderate (UK Class 2) compression hosiery, though compliance was lower with high compression.
- Two trials indicated that non-adherence to compression hosiery was strongly associated with ulcer recurrence.
Conclusions:
- Circumstantial evidence suggests compression therapy reduces venous leg ulcer recurrence.
- Strongest tolerable compression hosiery may offer better recurrence prevention, but compliance is key.
- Further research is needed on compression effectiveness in diverse settings.