Short-stretch or four-layer compression bandages: an overview of the literature

Venous ulcers are a common, costly occurrence. Treatment typically includes the use of short-stretch and four-layer bandages--both with demonstrated ability to increase venous return and healing rates. Which is superior is unclear. To determine whether short-stretch bandages or four-layer compression systems provide shorter healing times and fewer adverse events when used in adults with venous ulcers, a search of English-language literature was conducted using the search terms short-stretch bandages and wound care, compression bandages and wound care, compression and venous ulcers, four-layer compression and venous ulcers, and multilayer compression and venous ulcers. Data from 25 studies published between 1997 and 2006 were examined. Short-stretch and four-layer compression bandages were found to be equally as effective in managing the edema that compromises venous ulcer healing. Time to healing was found to be shorter using four-layer or one- to two-layer compression when compared to paste compression in 24 studies. Ankle brachial index is an important factor to consider in determining compression appropriateness. Generally, use of any compression system is better than no compression at all.