Clinical Question

Is compression therapy with bandages, stockings, or other devices safe and effective for treating venous ulcers in adults?

Evidence-Based Answer

Compared with treatment featuring no compression, therapy involving compression bandages or stockings results in faster and more complete ulcer healing over 12 months, reduced pain, and improved disease-specific quality of life. It is unclear whether compression increases adverse effects or is cost-effective.¹ (Strength of Recommendation: B, inconsistent, limited-quality patient-oriented evidence.)

Practice Pointers

Leg ulcers are open skin wounds that typically develop on the medial lower leg between the ankle and knee. Chronic leg ulcers can last weeks, months, or years. They often occur due to arterial or venous insufficiency or both, or other less common conditions.¹ Prevalence is unknown, but data from the 1980s suggest that 2 to 3 per 1,000 people have an active leg ulcer, and, in the United Kingdom, the rate increases with age to approximately 20 per 1,000 people older than 80 years.² Venous ulcers can be associated with pain, impaired mobility, reduced quality of life, and considerable health care costs. The authors of this Cochrane review sought to determine how compression therapy with bandages or stockings affects chronic venous ulcer healing and quality of life. Secondary outcomes included adverse effects, pain scores, and the cost-effectiveness of compression therapy.