The Efficacy of Multi-Layer Compression System and TIME-Concept for the Management of Leg Ulcers in Patients with Ambulatory Venous Hypertension – Truth and Myth

Abstract

Introduction: Venous leg ulcers are late manifestations of chronic venous insufficiency that can cause disability and serious complications. The elderly are more commonly affected. This study was designed to test the effectiveness, healing rates, quality of life and costs of multi-layer compression system and TIME-concept (tissue management, infection control, moisture balance and wound edge optimization) for the management of leg ulcers in patients with ambulatory venous hypertension.Methods: A prospective clinical study on 50 outpatients with venous leg ulcers, treated three times weekly for 12 weeks or until healed, with all patients consenting and independently mobile associated with a multi-layer compression system along with the TIME-concept treatment.Results: The study revealed that, the cohort was predominantly female (66%) with a mean age of 61.7 years. Universal presence of varicose veins and secondary lymphedema was noted. Specific conditions included postthrombotic syndrome (24%), calf pump dysfunction (8%), and venectomy history (32%). All patients achieved complete epithelialization, with an average healing time of 8.5±8.3 weeks and a median of 5.5 weeks (P=0.0064), with 88% healing within 12 weeks. No significant complications were reported. The median number of clinic visits was 16.5, and the median treatment cost was UAH 11,240.00. Patients’ satisfaction with the treatment was 100% according to completed wound healing.Conclusions: The study demonstrates effective management of venous leg ulcers using a multi-layer compression system and the TIME concept, achieving high healing rates with minimal complications and manageable treatment costs.