A systematic review of compression treatment for venous leg ulcers

Fletcher, Alison W.; Cullum, Nicky; Sheldon, Trevor

doi:10.1136/bmj.315.7108.576

Cited by 298 publications

(191 citation statements)

References 13 publications

(9 reference statements)

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“…Compression therapy within the setup of a leg ulcer clinic is widely recognised as the main modality for managing venous leg ulcers [17,18,51,52]. A previous study mentioned that contemporary dressing materials do not stimulate healing, and expenses are not clinically justified as they have no proven efficacy [19].…”

Section: Discussionmentioning

confidence: 99%

Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers

Sultan¹,

Tawfick²,

Kavanagh³

et al. 2016

Wound Healing - New Insights Into Ancient Challenges

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Topical wound oxygen (TWO 2 ) proposes an innovative therapy option in the management of refractory non-healing venous ulcers (RVU) that aims to accelerate wound healing. TWO 2 accelerates epithelialisation. This leads to the development of a higher tensile strength collagen, which lessens scarring and the risk of recurrence. Sixty-seven limbs with 67 ulcers were managed using TWO 2 therapy, and 65 limbs with 65 ulcers were managed using conventional compression dressings (CCD). The proportion of ulcers completely healed by 12 weeks was 76% in patients managed with TWO 2 , compared to 46% in patients managed with CCD (p < 0.0001). The mean reduction in ulcer surface area at 12 weeks was 96% in the TWO 2 therapy group, compared to 61% in patients managed with CCD. The median time to full ulcer healing was 57 days in the TWO 2 group, in contrast to 107 days in patients managed with CCD (p < 0.0001). TWO 2 patients had a significantly improved Quality-Adjusted Time Spent Without Symptoms of disease and Toxicity of treatment (Q-TWiST) compared to CCD patients, denoting an improved outcome (p < 0.0001). TWO 2 reduces the time needed for RVU healing and is successful in pain alleviation and MRSA elimination. TWO 2 therapy radically degrades recurrence rates. Utilising diffused oxygen raises the capillary partial pressure of oxygen (Po 2 ) levels at the wound site, stimulating epithelialisation, and granulation of new healthy tissue. Taking the social and individual aspects of chronic venous ulceration into account, the use of TWO 2 can provide an overwhelmingly improved quality of life for long-time sufferers of this debilitating disease.

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Section: Discussionmentioning

confidence: 99%

Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers

Sultan¹,

Tawfick²,

Kavanagh³

et al. 2016

Wound Healing - New Insights Into Ancient Challenges

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“…A systematic review 35 (updated by Cullum and colleagues 31 ) concluded that patients with venous leg ulcers who receive compression therapy are ; however, these trials involved only 328 patients in total, and therefore even taken together they lacked power to detect clinically important differences in leg ulcer healing.…”

Section: Clinical Effectiveness Of Different Bandage Systemsmentioning

confidence: 99%

“…Because of the methodological weaknesses of studies identified in the review by Fletcher and colleagues 35 we felt that a study that examined the clinical and cost-effectiveness of different compression systems was justified.…”

Section: Background To Venous Ulcer Study (Venus) Trialmentioning

confidence: 99%

VenUS I: a randomised controlled trial of two types of bandage for treating venous leg ulcers

Iglesias¹,

Nelson²,

Cullum

et al. 2004

Health Technol Assess

116

105

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“…Medical hosiery is a useful and convenient method of applying a graduated compression to prevent the development or recurrence of leg ulcers. Compression bandages currently represent the treatment of choice [9,10]. However, hosiery and compression bandages are of limited value in the treatment of active ulceration, difficult to apply over dressings, tend to lose mechanical strength and stiffness due to breakdown of fibres involved [11], and are expensive [12].…”

Section: Introductionmentioning

confidence: 99%

Feasibility study of polyurethane shape-memory polymer actuators for pressure bandage application

Ahmad

Luo

Miraftab

2012

Science and Technology of Advanced Materials

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The feasibility of laboratory-synthesized polyurethane-based shape-memory polymer (SMPU) actuators has been investigated for possible application in medical pressure bandages where gradient pressure is required between the ankle and the knee for treatment of leg ulcers. In this study, using heat as the stimulant, SMPU strip actuators have been subjected to gradual and cyclic stresses; their recovery force, reproducibility and reusability have been monitored with respect to changes in temperature and circumference of a model leg, and the stress relaxation at various temperatures has been investigated. The findings suggest that SMPU actuators can be used for the development of the next generation of pressure bandages.

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A systematic review of compression treatment for venous leg ulcers

Cited by 298 publications

References 13 publications

Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers

Topical Wound Oxygen Versus Conventional Compression Dressings in the Management of Refractory Venous Ulcers

VenUS I: a randomised controlled trial of two types of bandage for treating venous leg ulcers

Feasibility study of polyurethane shape-memory polymer actuators for pressure bandage application

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