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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, Baines Wing, Leeds, UK, LS2 9UT.
The Cochrane Database of Systematic Reviews
|September 10, 2014
Summary
Compression hosiery effectively prevents venous leg 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
- Dermatology
- Wound Care
Background:
- Venous leg ulcers affect up to 1% of adults, primarily due to venous hypertension.
- Compression therapy is the cornerstone for healing and preventing recurrence.
- Despite healing, ulcers frequently recur, necessitating ongoing compression management.
Purpose of the Study:
- To evaluate the efficacy of compression in preventing venous ulcer recurrence.
- To determine if specific compression levels, types, or brands are superior for prevention.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) evaluating compression for venous ulcer recurrence prevention.
- Searched major databases including Cochrane Wounds Group Register, MEDLINE, EMBASE, CINAHL, and CENTRAL.
- Data extraction and risk of bias assessment performed independently by two reviewers.
Main Results:
- One RCT showed compression significantly reduced 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 with high-compression at three years, the other found no difference at five years.
- Patient compliance was higher with moderate-compression hosiery, and no significant difference in recurrence was found between two medium-compression brands.
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 long-term venous ulcer prevention.
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