A systematic review of compression treatment for venous leg ulcers.

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Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers.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.