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Compression for preventing recurrence of venous ulcers.
E Andrea Nelson1, Sally E M Bell-Syer
1School of Healthcare, University of Leeds, Leeds, UK. e.a.nelson@leeds.ac.uk.
The Cochrane Database of Systematic Reviews
|August 17, 2012
Summary
Compression hosiery significantly reduces venous ulcer recurrence compared to no compression. However, evidence on optimal compression levels and types for preventing recurrence is limited, with high patient intolerance noted.
Area of Science:
- Vascular Medicine
- Wound Healing
- Dermatology
Background:
- Venous leg ulcers affect up to 1% of adults, primarily due to venous hypertension.
- Compression therapy is the mainstay for healing and preventing recurrence, typically involving hosiery.
- Despite healing, ulcers frequently recur, necessitating ongoing preventive measures.
Purpose of the Study:
- To evaluate the effectiveness of compression in preventing venous ulcer recurrence.
- To determine if specific compression levels, types, or brands are superior for preventing recurrence.
Main Methods:
- Systematic review of randomized controlled trials on compression bandages or hosiery for venous ulcer recurrence prevention.
- Searched multiple databases including Cochrane Wounds Group Register, CENTRAL, MEDLINE, EMBASE, and CINAHL up to March 2012.
- Data extraction and risk of bias assessment were performed independently by two reviewers.
Main Results:
- One trial showed compression significantly reduced venous ulcer recurrence by 54% at six months compared to no compression.
- Two trials comparing high-compression (UK Class 3) vs. moderate-compression (UK Class 2) hosiery showed mixed results: one found reduced recurrence at three years, the other no difference at five years.
- Patient compliance was higher with moderate-compression hosiery; no significant difference was found between two types of moderate-compression hosiery in another trial. No trials on compression bandages for recurrence prevention were identified.
Conclusions:
- Compression hosiery is effective in reducing venous ulcer reulceration compared to no compression.
- Evidence is insufficient to recommend specific compression levels, types, or brands due to conflicting results and high patient intolerance.
- Further research is needed to optimize compression strategies for preventing venous ulcer recurrence.
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