Graduated Compression Elastic Stockings Reduce Lipodermatosclerosis and Ulcer Recurrence

Abstract

Objective: To assess the effect of elastic stockings on reducing the area of lipodermatosclerosis in patients with healed venous ulceration. Design: Patients in this study were part of a randomised controlled trial to assess elastic stockings in preventing venous ulcer recurrence. Setting: Leg ulcer clinic at a tertiary teaching hospital. Patients: Consecutive consenting patients with leg ulcers due to venous disease alone, that had healed 2 weeks previously. Interventions: Patients were randomised to below-knee graduated compression stockings (Venosan 2003) or no stockings. Main outcome measures: Patients had the area of lipodermatosclerosis measured on admission to the study and at 6-monthly intervals. Time to ulcer recurrence was also recorded for a 2-year follow-up period. Results: One hundred and fifty-three patients were randomised to the main study (stockings 72, no stockings 81); 52 had re-ulcerated by 6 months (15 stockings, 37 no stockings). Lipodermatosclerosis was significantly reduced after 6 and 12 months in those patients wearing stockings but not in the control group (repeat measures ANOVA p = 0.01, p = 0.04). The initial area of lipodermatosclerosis was significantly larger in those patients who re-ulcerated within 2 years of entering the study compared with those who did not re-ulcerate (re-ulceration, 293 cm2; no re-ulceration, 50 cm2). Conclusions: Elastic stockings alone can improve the skin changes of lipodermatosclerosis and lower the rate of ulcer recurrence.

Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study

“…The 12-month recurrence rate (44%) in this sample is similar to levels reported previously in the literature in patient groups without controlled interventions , Vandongen & Stacey 2000, Fassiadis et al 2002. Moffatt and Dorman (1995) and Vowden and Vowden (2005) found that the highest rates of recurrence were within 3 months of healing, and likewise nearly half of those who recurred in this study did so within the first 3 months of healing.…”

“…Previous evidence on the use of compression therapy to prevent recurrence has shown its effectiveness (Nelson et al 2000, 2006, Vandongen & Stacey 2000 and results from this study support those findings. This study showed no difference in the risk of recurrence between participants wearing Class 2 or Class 3 hosiery; however, there were only small numbers wearing Class 3 hosiery (n = 10).…”

Diagnosis and management of venous leg ulcers

“…There is high level evidence from a randomised controlled trial that compression reduces recurrence,60 and guidelines advocate compression therapy combined with interventions for superficial venous incompetence to reduce the risk of recurrence 19213538516162…”

Consensus statement on the symptom‐based treatment of chronic venous diseases

“…There is good evidence for the effi cacy of compression therapy -at various stages of chronic venous disorders -with regard to signifi cant edema reduction and signifi cant improvement of symptoms [ 22,[24][25][26][27][28][29][30][31][32][33] .…”