New research from the UK has shown that compression stockings are just as effective at treating venous leg ulcers as four-layer traditional bandages, promising cost savings for the National Health Service.
The research, published in The Lancet, shows that sufferers treated using compression stockings also reported less recurrence and needed fewer nurse visits, making their use more economically viable.
Defined by the National Institute for Heath and Care Excellence (resource no longer available at cks.nice.org.uk) (NICE) as “the loss of skin below the knee on the leg or foot, which takes more than 6 weeks to heal,” venous leg ulcers are most common among older adults, aged 65 and above.
And 6 weeks may be an optimistic estimate of healing time – with research suggesting 9 months as the mean duration of these ulcers, and 66% of sufferers reporting a history of ulcerations lasting longer than 5 years.
Venous leg ulcers are extremely common in the US, affecting between 500,000 and 2 million people each year.
Venous leg ulcers occur when the veins in the leg become blocked or damaged, resulting in skin breakdown and impaired healing. These chronic wounds are painful, likely to recur and impact negatively on quality of life. Obesity and immobility also increase the risk of developing the ulcers.
Typically, leg ulcers are treated with multi-layer compression bandages. But these have disadvantages, as Dr. Jo Dumville, senior lecturer at the The University of Manchester’s School of Nursing, Midwifery and Social Work, explains:
“Compression bandages are bulky, unattractive and may interfere with normal footwear; they can also be costly as they take time to apply and often require frequent nurse visits to change them.”
The study, known as Venous leg Ulcer Study IV (VenUS IV), recruited 454 patients for the trial. They were randomly allocated either the stockings or the traditional bandages.
The results showed the median time it took for the ulcer to heal was similar in both cases – 99 days for the stocking-clad participants, compared with 98 days for the bandage group.
The researchers noted that not everyone liked wearing the stockings, and that more people changed from this to another treatment, compared with the group using traditional compression bandages – 38% against 27%.
Nikki Stubbs, clinical lead at Leeds Community Healthcare NHS Trust, says:
“The findings support the use of compression stockings for some people with venous leg ulcers. Where appropriate, the day-to-day application of stockings can be undertaken by patients, carers and a range of health professionals. From a patient perspective this may promote independence as well as enabling the NHS to maximize the use of its resources to best effect.”