Compression Therapy Is Not Contraindicated in Diabetic Patients with Venous or Mixed Leg Ulcer.

Area of Science:

• Vascular Surgery
• Dermatology
• Diabetology

Background:

• Venous leg ulcers (VLU) and mixed leg ulcers (MLU) are challenging conditions.
• Compression therapy (CT) is a cornerstone treatment for VLU.
• The safety and efficacy of CT in diabetic patients, especially those with arterial impairment, require further investigation.

Purpose of the Study:

• To evaluate the safety and effectiveness of compression therapy (CT) in diabetic patients with Venous Leg Ulcers (VLU).
• To assess CT's impact on healing time in diabetic patients with Mixed Leg Ulcers (MLU), characterized by moderate arterial impairment (Ankle-Brachial Pressure Index 0.5-0.8).

Main Methods:

• A sub-analysis compared healing times between diabetic patients (DP) and non-diabetic patients (NDP).
• Patients with recalcitrant VLU or MLU received tailored inelastic CT (<40 mm Hg for MLU, >60 mm Hg for VLU) and ultrasound-guided foam sclerotherapy (UGFS).
• Healing times were compared between 73 DP (40 VLU, 33 MLU) and 107 NDP (69 VLU, 38 MLU).

Main Results:

• Median healing time for VLU was 25 weeks in NDP and 28 weeks in DP (p=0.09).
• Median healing time for MLU was 27 weeks in NDP and 29 weeks in DP (p=-0.19).
• No statistically significant difference in healing time was observed between diabetic and non-diabetic patients in either VLU or MLU groups.

Conclusions:

• Tailored compression regimens and foam sclerotherapy are effective for treating recalcitrant VLU and MLU in both diabetic and non-diabetic patients.
• Diabetes appears to have a minor or negligible effect on the healing time of these leg ulcers when treated with this combined approach.
• Compression therapy can be safely applied to diabetic patients with VLU and MLU, even with moderate arterial impairment.