Papers

A systematic review of compression treatment for venous leg ulcers

^a NHS Centre for Reviews and Dissemination, University of York, York, ^b Department of Health Studies, University of York, York Y01 5DD

Correspondence to: Dr Cullum n.cullum@pulse.york.ac.uk

Objective: To estimate the clinical and cost effectiveness of compression systems for treating venous leg ulcers.
Methods: Systematic review of research. Search of 19 electronic databases including Medline, CINAHL, and Embase. Relevant journals and conference proceedings were hand searched and experts were consulted.
Main outcome measures: Rate of healing and proportion of ulcers healed within a time period.
Study selection: Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers.
Results: 24 randomised controlled trials were included in the review. The research evidence was quite weak: many trials had inadequate sample size and generally poor methodology. Compression seems to increase healing rates. Various high compression regimens are more effective than low compression. Few trials have compared the effectiveness of different high compression systems.
Conclusions: Compression systems improve the healing of venous leg ulcers and should be used routinely in uncomplicated venous ulcers. Insufficient reliable evidence exists to indicate which system is the most effective. More good quality randomised controlled trials in association with economic evaluations are needed, to ascertain the most cost effective system for treating venous leg ulcers.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Dressings for venous leg ulcers: systematic review and meta-analysis

Simon Palfreyman, E Andrea Nelson, and Jonathan A Michaels
BMJ 2007 335: 244. [Abstract] [Full Text] [PDF]

Cost effectiveness of community leg ulcer clinics

Paul J Whatling, Robert B Galland, John C Platt, C V Ruckley, Peter J Franks, Christine J Moffatt, and C Jane Morrell
BMJ 1998 317: 1079. [Extract] [Full Text]

Effectiveness and cost effectiveness of compression bandages should be shown

Peter J Franks and Christine J Moffatt
BMJ 1998 316: 860. [Extract] [Full Text] [PDF]

Related external webpages:

This article has been cited by other articles:

• Palfreyman, S., Nelson, E A., Michaels, J. A (2007). Dressings for venous leg ulcers: systematic review and meta-analysis. BMJ 335: 244-244 [Abstract] [Full text]  
• Beele, H., de la Brassine, M., Lambert, J., Suys, E., De Cuyper, C., Decroix, J., Boyden, B., Tobback, L., Hulstaert, F., Schepper, S. D., Brissinck, J., Delaey, B., Draye, J.-P., Deene, A. D., Waele, P. D., Verbeken, G. (2005). A Prospective Multicenter Study of the Efficacy and Tolerability of Cryopreserved Allogenic Human Keratinocytes to Treat Venous Leg Ulcers. INT J LOW EXTREM WOUNDS 4: 225-233 [Abstract]  
• Moffatt, C.J., Franks, P.J., Doherty, D.C., Martin, R., Blewett, R., Ross, F. (2004). Prevalence of leg ulceration in a London population. QJM 97: 431-437 [Abstract] [Full text]  
• Theopold, C., Yao, F., Eriksson, E. (2004). Gene Therapy in the Treatment of Lower Extremity Wounds. INT J LOW EXTREM WOUNDS 3: 69-79 [Abstract]  
• Cabrera, J., Redondo, P., Becerra, A., Garrido, C., Cabrera, J. Jr, Garcia-Olmedo, M. A., Sierra, A., Lloret, P., Martinez-Gonzalez, M. A. (2004). Ultrasound-Guided Injection of Polidocanol Microfoam in the Management of Venous Leg Ulcers. Arch Dermatol 140: 667-673 [Abstract] [Full text]  
• Nelson, E A. (2004). 4 layer bandaging reduced healing time and saved nursing time and cost in venous leg ulcer. Evid. Based Med. 9: 25-25 [Full text]  
• de Araujo, T., Valencia, I., Federman, D. G., Kirsner, R. S. (2003). Managing the Patient with Venous Ulcers. ANN INTERN MED 138: 326-334 [Abstract] [Full text]  
• Sarkar, P K, Ballantyne, S (2000). Management of leg ulcers. Postgrad. Med. J. 76: 674-682 [Abstract] [Full text]  
• Hafner, J., Botonakis, I., Burg, G. (2000). A Comparison of Multilayer Bandage Systems During Rest, Exercise, and Over 2 Days of Wear Time. Arch Dermatol 136: 857-863 [Abstract] [Full text]  
• DePalma, R. G., Kowallek, D., Spence, R. K., Caprini, J. A., Nehler, M. R., Jensen, J., Goldman, M. P., Bundens, W. P. (1999). Comparison of Costs and Healing Rates of Two Forms of Compression in Treating Venous Ulcers. VASC ENDOVASCULAR SURG 33: 683-690 [Abstract]  
• Margolis, D. J., Berlin, J. A., Strom, B. L. (1999). Risk Factors Associated With the Failure of a Venous Leg Ulcer to Heal. Arch Dermatol 135: 920-926 [Abstract] [Full text]  
• Skin Substitute Consensus Development Panel, (1999). Nonoperative Management of Venous Leg Ulcers: Evolving Role of Skin Substitutes. VASC ENDOVASCULAR SURG 33: 197-210 [Abstract]  
• Tinkler, A., Hotchkiss, J., Nelson, E A., Edwards, L. (1999). Implementing evidence-based leg ulcer management. Evid. Based Nurs. 2: 6-8 [Full text]  
• Palfreyman, S. J, Lochiel, R., Michaels, J. A (1998). A systematic review of compression therapy for venous leg ulcers. Vasc Med 3: 301-313 [Abstract]  
• Whatling, P. J, Galland, R. B, Platt, J. C, Ruckley, C V, Franks, P. J, Moffatt, C. J, Morrell, C J. (1998). Cost effectiveness of community leg ulcer clinics. BMJ 317: 1079a-1079 [Full text]  
• Fernell, J. (1998). Review: compression treatment improves healing of venous leg ulcers. Evid. Based Nurs. 1: 50-50 [Full text]  
• Falanga, V., Margolis, D., Alvarez, O., Auletta, M., Maggiacomo, F., Altman, M., Jensen, J., Sabolinski, M., Hardin-Young, J., and the Human Skin Equivalent Investigators Group, (1998). Rapid Healing of Venous Ulcers and Lack of Clinical Rejection With an Allogeneic Cultured Human Skin Equivalent. Arch Dermatol 134: 293-300 [Abstract] [Full text]  
• (1997). Compression Treatment Is Good for Venous Leg Ulcers. Journal Watch Dermatology 1997: 15-15 [Full text]  
• (1997). COMPRESSION TREATMENT IS GOOD FOR VENOUS LEG ULCERS. JWatch General 1997: 3-3 [Full text]