Clinical Efficacy and Biomechanical Behavior of Different Compression Systems in Venous Ulcers: Pressure, Stiffness...

Venous leg ulcers are the most severe manifestation of chronic venous insufficiency, and their treatment is based on compression therapy, whose effectiveness depends on the magnitude of the pressure and the biomechanical properties of the system. Doubts persist about the actual correlation between interface pressure, bandage stiffness and clinical outcomes in real-world practice.

To compare the clinical efficacy and biomechanical behavior of different multicomponent compression systems in venous leg ulcers, analyzing the relationship between interface pressure, static stiffness, edema reduction and variation in the wound area.

This is a prospective, observational and multicenter study in six districts/health areas of Andalusia, in adults with active venous ulcers attended by Advanced Practice Nurses in Complex Chronic Wounds. Several multi-component compression systems were applied, and interface pressure was monitored using Tight Alright^® at three points on the leg for 96 h, recording final pressure, static stiffness, perimeters and ulcer area.

All systems achieved a reduction in leg circumference, more marked at the proximal points, evidencing an overall decongestant effect. The correlation between final pressure and edema reduction was weak, and relevant differences were observed in the reduction in ulcer area, with Urgo K2 and CPK Compress 2 standing out with decreases of more than 50% compared to medium or low yields of other systems with comparable pressures. The static stiffness analysis showed specific patterns according to system and leg size, as well as a heterogeneous longitudinal distribution of pressure.

The efficacy of compression in venous ulcers depends on both the interface pressure and the design and biomechanical behavior of the system, with clinically relevant differences between multicomponent dressings. Multipoint pressure and stiffness monitoring provides useful information to optimize system selection and support decisions based on biomechanical parameters and standardized clinical outcomes.