Short-stretch Compression Bandages Research Articles

Nursing students' skills in applying short-stretch compression bandages using the control of compression bandaging score.

To assess the feasibility using the Control of Compression Bandaging (CCB) score to measure skills development on short-stretch compression therapy during a second-year nursing students' workshop. A quasi-experimental pilot study with one group. All students followed a blended learning unit comprising an e-learning unit on leg ulcers and compression therapy including videos, followed by hands-on workshops where they could exercise how to apply short-stretch compression bandages. Clinical nurse specialists in wound care collected pre- and post-workshop measures. Data collection included feasibility, absolute pressure under compression bandages and the CCB score. Six clinical nurse specialists (CNSs) collected data and 16 students participated in this pilot study. The mean application time was 8.02 minutes (min=2, max=20) pre and 9.25 minutes (min=5, max=17) post workshop. Pressure under compression bandages increased at the forefoot (P=0.01) and the calf muscle base (P=0.03) post workshop. One extreme outlier was observed. In addition, the CCB score increased from 3.57 to 4.47 (P=0.16). Using pressure measuring devices was described as essential by all the CNSs and the CCB score was easy to use. Using the CCB score and pressure measuring devices were feasible during an undergraduate education session. Recruitment procedure and modality of data collection were satisfactory. This score may be a valuable way to assess students' skills in short-stretch compression therapy. If used for formal assessment, a passing score should be defined.

Getting Ready for Wound Certification: Factors Impeding Wound Healing.

Getting Ready for Wound Certification: Factors Impeding Wound Healing.

Lay Caregivers Education in Multicomponent Compression Bandaging in Obese Patients with Lower Limb Edema: A Case-Control Pilot Study.

Background: A report on the usefulness of the instruction of lay carers in multilayer short-stretch compression bandaging within the initial intensive phase physical treatment of mixed-etiology chronic lower limb edema. Methods and Results: In a group of adult obese patients (including 24 females) with venous insufficiency and chronic bilateral lower limb edema, and without a history of physical therapy, 20 (ambulatory managed) were bandaged once daily (four layers, short stretch with cotton tube, and foam padding underneath) for 3 weeks (Monday-Friday) by skilled physiotherapists, and in 20 cases (education group, EG), the patients' lay carers were educated by these physiotherapists according to the same regime during one session. The outcome measures included limb volume (the method of circumference measurement with a tape at 4 cm intervals) after 1, 3, and 6 months, the time to reach the maintenance phase, the frequency of complementary bandaging during this phase, and the sense of self-efficacy (General Self-Efficacy scale, GSEs). No significant differences were noted between the two groups in the baseline measurements of age, body mass, and limb volume. The carers were able to apply compression bandages in all cases during the observation period. The time to reach the maintenance phase was longer in EG (6 vs. 1 weeks; p < 0.001). A similar median reduction in edema volume was observed at the end of the bandaging period, which continued for 3 and 6 months. It was only in EG that further improvement between 1 and 3 months was observed (p = 0.008). All participants represented an equally high optimistic sense of personal competence (GSEs). Conclusions: The instruction of lay carers in bandaging may provide a simple clinically effective solution for lower limb edema management, thus lowering its costs.

Knee Replacement Bandaging Study (KReBS) evaluating the effect of a two-layer compression bandage system on knee function following total knee arthroplasty: study protocol for a randomised controlled trial

BackgroundData from a feasibility study suggest that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that may improve patient-reported health outcomes, and that it is feasible to recruit to a full-scale study.MethodsWe will conduct a randomised controlled trial (RCT) of 2600 adult patients, which has 80% power to detect a 1 point difference in the Oxford Knee Score (a patient self-reported assessment of knee pain and function) at 52 weeks. Short stretch compression bandaging will be compared with standard wool and crepe bandaging following total knee arthroplasty. Recruitment will take place in orthopaedic units across the United Kingdom. Secondary outcomes include the EuroQol 5 Dimensions (EQ-5D)-5 L and EQ-5D-3 L scores, pain, length of hospital stay, and complications.DiscussionThe Knee Replacement Bandaging Study (KReBS) is a large study which aims to contribute to the evidence base for informing clinical decisions for the use of compression bandaging following knee arthroplasty.Trial registrationInternational Standard Randomised Controlled Trial Register, ISRCTN 87127065. Registered on 20 February 2017.

A Meta-analysis to Compare Four-layer to Short-stretch Compression Bandaging for Venous Leg Ulcer Healing

Compression therapy is the standard of care for venous leg ulcers (VLUs), and some evidence suggests 4-layer compression is more effective than short-stretch bandages. A meta-analysis was conducted to compare the effectiveness of these 2 compression bandages for venous ulcer healing. In March 2016, a systematic review of the literature was conducted to identify randomized controlled trials. Databases used included Pubmed/MEDLINE, EMBASE, Cochrane Central, the Cumulative Index of Nursing and Allied Health Literature, and the Latin American and Caribbean of Health Sciences Information System. Search terms were varicose ulcer, venous leg ulcer, venous ulceration, leg ulcer, compression bandages, compressive therapy, multilayer system, four-layer system, elastic bandages, short-stretch bandage, short-stretch system, and inelastic bandage. No publication time or language restrictions were imposed, but findings subjected to analysis were limited to results of research that reported healing and healing time using 4-layer and short-stretch compression only. The quality of the studies was assessed using the Jadad scale. Data extracted included study design, country, target population demographics, VLU clinical aspects at baseline, sample size, interventions applied, follow-up period, complete healing, and healing time as outcomes. Relative risk was calculated considering a 95% confidence interval for dichotomous variables (complete healing), and heterogeneity was statistically assessed among the studies using the chi-squared test assuming random effect when I2 ≥50%. The search yielded 557 papers; 21 met the study criteria for full-text analysis, and 7 met the meta-analysis inclusion criteria. The studies included 1437 patients, average age 70 (range 23-97) years with 1446 venous leg ulcers. Most (5) studies were classified as being at low risk of bias. At 12 and 16 weeks, 259 ulcers (51.08%) healed completely in the 4-layer and 234 (46.34%) in the short-stretch bandage groups, respectively (P = .41). At 24 weeks, 268 ulcers (69.07%) in the 4-layer and 257 (62.23%) in the short-stretch bandage groups, respectively, had healed (P = .16). The 2 bandage systems evaluated were similar in achieving complete healing at their respective study endpoints. The average time for healing was 73.6 ± 14.64 days in the 4-layer and 83.8 ± 24.89 days in the short-stretch bandage groups; no meta-analysis was done for this outcome due the inability to retrieve all the individual patient data for each study. The choice of compression system remains at the discretion of the clinicians based on evidence of effectiveness, patient tolerability, and preference. Additional randomized controlled trials to compare various wound and patient outcomes between different compression systems are warranted.

Diuretics Combined With Compression in Resistant Limb Edema of Advanced Disease—A Case Series Report

IntroductionThe extremity edema of advanced disease is a common, multifactorial feature, which impairs patients' activities and quality of life. The most frequently chosen management is based on combined decongestive physiotherapy or pharmacotherapy (with diuretics or steroids). Subcutaneous lymphatic drainage in refractory edema may decrease the swelling, prevent spontaneous lymphorrhea, but also increase the risk of infection. Safe and effective conservative management in diuretics-resistant edemas is lacking. The objective of this prospective, observational study was to assess the effectiveness and tolerability of combined physiotherapeutic and diuretic therapy in edemas refractory to parenteral diuretics. MethodsA group of 19 patients with advanced disease and severe bilateral leg edema resistant to parenteral diuretic therapy were treated for three days with a combination of multilayer short-stretch compression bandaging and furosemide in hypersaline intravenous infusion. ResultsA clinically meaningful decrease in mean limb volume (of 1.52 L; 20.6%; P < 0.0001)—strongly correlating with patients' weight loss (ρ = 0.71; P = 0.0001), with a lowering of the intensity of complaints—was achieved. The treatment was well tolerated, without decreasing the performance status in any patient. Stable levels of blood pressure, laboratory kidney profile (potassium, sodium, creatinine clearance), and serum albumin were observed. Maintenance of the achieved results with a good compliance was seen during an informal follow-up at the hospice. ConclusionThe combination of compression therapy with hypersaline diuretics could be considered as a valuable option for refractory cases of limb edema in advanced disease.

STICKS study \u2013 Short-sTretch Inelastic Compression bandage in Knee Swelling following total knee arthroplasty \u2013 a feasibility study

BackgroundPostoperative knee swelling is common and impairs early postoperative function following total knee arthroplasty. It was hypothesised that the use of a short-stretch, inelastic compression bandage would reduce knee swelling and improve pain and early function. The aim of this study was to provide preliminary data and test feasibility with a view to informing a larger, future trial.MethodsFifty consecutive patients selected for primary total knee arthroplasty underwent distance randomisation to receive a short-stretch, inelastic compression bandage or a standard wool and crepe bandage for the first 24 h postoperatively. Study feasibility including recruitment rates, retention rates and complications were analysed. The Oxford Knee Score, the EQ-5D-3L index score, knee swelling, knee range of motion, visual analogue pain score and length of stay were compared between groups. Analysis of covariance (ANCOVA) was performed adjusting for the preoperative measurement.ResultsSixty-eight percent of eligible patients were recruited into the trial. The retention rate was 88%. There were no complications regarding compression bandage use. There was a greater mean but non-significant improvement in Oxford Knee Score (p = 0.580; point estimate = 2.1; 95% CI −3.288 to 7.449) and EQ-5D-3L index score (p = 0.057; point estimate = 0.147; 95% CI −0.328 to 0.005) in the compression bandage group at 6 months. There was no significant difference between groups regarding knee swelling, knee range of motion, visual analogue pain score, complications and length of stay.ConclusionPreliminary data suggests that the use of an inelastic, short-stretch compression bandage following total knee arthroplasty is a safe technique that is acceptable to patients. A larger, multicentre trial is required to determine its effect postoperatively.Trial registrationThe study was registered with Current Controlled Trials, identifier: ISRCTN86903140. Registered on 30 May 2013.

Effect of proprioceptive neuromuscular facilitation D2 flexion and breathing exercises on lymphedema without a short stretch compression bandage.

[Purpose] The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation (PNF) D2 flexion and breathing exercises in a patient with lymphedema (LE). [Subject] This report describes a 57-year-old woman with LE in whom a short-stretch compression bandage (SSCB) could not be used for treatment because of skin itching and redness. [Methods] The patient received complex decongestive therapy without a SSCB. Next, PNF D2 flexion and breathing exercises were conducted three times per week for 14 weeks (36 times). [Results] As a result, the circumference of the armpit was reduced by 0.5 cm; that of 10 cm above the elbow, by 1 cm; that of the elbow, by 0.5 cm; that of 10 cm below the elbow, by 1 cm; and that of the back of the hand, by 0.5 cm. A total of 100 mL (9.4%) of body water was eliminated from the right upper extremity, and moisture ratio was reduced by 0.005%. Finally, range of motion was improved to 20° flexion, 60° abduction, 40° external rotation, and 10° internal rotation. [Conclusion] This study showed that PNF D2 flexion and breathing exercises were effective in reducing LE and improving range of motion.

Comment to: Catheter-directed foam sclerotherapy for insufficiency of the great saphenous vein: occlusion rates and patient satisfaction after one year, by Williamsson C, Danielsson P, Smith L. Phlebology 2012:1-6.

Between November 2007 and October 2008, 100 consecutive symptomatic patients with verified axial reflux in the GSV were treated with a catheter-directed foam sclerosation technique (CDS). CDS delivers the foam during a short period of time directly to the intended site, along the length of the GSV, with less impact from surrounding factors. The catheter induces a vasospasm which might further enhance drug interaction with the vein wall. Median age was 52.5 years (range 18&ndash;92), 28 men and 72 women. All patients had visible varicose veins. Twenty-three had recurrent varicose veins. The treatment was performed in the outpatient clinic by a team consisting of two vascular surgeons and two nurses. Exclusion criteria were allergy to polidocanol, a very tortuous vein (which could make the catheters impossible to advance) or a GSV diameter exceeding 10 mm at the terminal valve. The skin was infiltrated with local anesthesia. The vein was accessed by a micro-puncture introducer set and a 0.35 Fr guide wire was advanced proximally under US surveillance and positioned at the SFJ. A catheter was introduced over the guide wire and positioned approximately 2 cm distal to the SFJ and the guide wire was removed. The table was slightly tilted to elevate the leg to empty the GSV. Ten mL sclerosing foam (SF) was made by mixing 2 mL chilled 3% polidocanol and 8 mL air. The SFJ and site of puncture was compressed for five minutes and the thigh massaged to fill superficial varicosites with foam. No additional local injection of foam was given. All patients wore two-layer short stretch compression bandages for one to five days after treatment. Evaluation with US was performed at two weeks and at one year after treatment. Foam delivery along the GSV was technically successful in 94 of the 100 patients. The median time for the procedure was 22 (8&ndash;90) min. The complete treatment exceeded 30 min in 20 patients, but only in two patients following the 50th patient. At the US control two weeks after treatment, the GSV was completely occluded in 92 of the 94 successfully treated patients. At the one-year follow-up, 84% (79/94) were satisfied with the result. The one-year US showed that 70% (64/91) of the GSVs were completely occluded, 15% (14/91) of the GSVs were recanalized and 14% (13/91) were partly occluded. No major complications occurred such as visual disturbance, pulmonary embolism, DVT or infection. Two patients had superficial thrombophlebitis; at the one-year follow-up 26 patients had pigmentations to some extent. The cost for the drugs and the single-use medical material was calculated to be 106 EUR.

Randomized clinical trial of three‐layer tubular bandaging system for venous leg ulcers

The safety and efficacy of three-layer (3L) tubular bandaging as a treatment for venous ulcer healing has not been evaluated despite its use in many clinical settings to treat people with venous leg ulcers. We evaluated the safety and efficacy of 3L tubular bandage compared with short-stretch compression bandage to heal venous ulcers in a multicenter, open-label, parallel-group, randomized controlled trial. We randomized 45 patients with venous leg ulcers of up to 20 cm(2) area and an ankle brachial pressure index of >0.8 from hospital outpatient wound clinics in Victoria and Queensland, Australia. We measured time to healing and percentage reduction of wound size from baseline to week 12. Secondary outcomes were proportion of ulcers healed, self-reported compliance of compression bandage, and health-related quality of life, costs, recurrence rates, and adverse events. A total of 27 ulcers healed, the proportion of healed ulcers was higher for the 3L group (17/23 [74%] vs. 10/22 [46%]) (p = 0.05). Reported bandage tolerance at all treatment visits was 21 (91%) in 3L group vs. 17 (73%) (p = 0.10). There was no difference between the groups in adverse events. Costs were substantially less in 3L group.

Compression bandaging: types and skills used in practical application

This article discusses long- and short-stretch compression bandages and the theory underpinning their practical application. The Laplace equation is outlined to estimate sub-bandage pressures. Challenges associated with applying therapeutic levels of compression include bandage tension, number of layers, limb circumference and bandage width. Multi-layer bandaging is important for the management of chronic oedema. As poor bandaging techniques can lead to tissue damage, pain, oedema and necrosis, practitioners should be skilled in their application. Through collaboration between specialists and generalists and ongoing practice development, patient outcomes can be improved.

Prospective, Randomized, Controlled Trial Comparing a New Two-Component Compression System with Inelastic Multicomponent Compression Bandages in the Treatment of Leg Lymphedema

New, less-bulky, short-stretch compression bandages could be a valuable alternative in the management of lymphedema of the leg. To compare the effectiveness of a two-component compression (2CC) system in the treatment of leg lymphedema with that of the traditional treatment with conventional inelastic multicomponent compression bandages (IMC). Thirty hospitalized patients with moderate to severe unilateral lymphedema (stage II-III) of the leg were included. Patients were divided in two groups; one (n=15) received a 2CC, and the other (n=15) received IMC. Primary outcome was volume reduction of the affected leg; secondary outcome was loss of interface pressure. Median leg volumes before bandaging were 4,150 mL (2CC) and 4,360 mL (IMC). Median volume reduction after 2 hours was 120 mL (2.9%) with the 2CC system and 80 mL (1.8%) with IMC (p>.05). After 24 hours, volume reduction was 8.4% and 4.4% respectively (p>.05). Interface pressure dropped significantly within 2 hours of bandage application in both groups. Our results indicate that the 2CC system forms a suitable alternative to IMC in the conventional treatment of moderate to severe lymphedema.

Lymphedema

Lymphedema therapy has gone by many names in the recent past, being referred to as complex decongestive therapy, complex physical therapy, or decongestive lymphatic therapy, among others. There are two phases of lymphedema treatment: the acute "intensive" phase and the maintenance phase. In the acute phase of treatment, the individual is typically wrapped with medical short-stretch compression bandages; receives a therapeutic exercise routine, skin care, and education; and undergoes manual lymphatic drainage by a specially trained physical therapist or healthcare professional. In the maintenance phase, the goals are for the individual to be able to wear a well-fitted appropriate gradient pressure garment during the day and compression bandaging (or a device that serves as an alternative to bandaging) at night, to maintain good skin care, to continue with therapeutic exercise, and to self-perform manual lymphatic drainage (or use a mechanical device that can perform manual lymphatic drainage) for the area of the body with impaired lymphatics. The effectiveness of the various components in each phase, as well as the motivation and compliance of the patient, differs. Further randomized trials are required to determine which component or combination of components in complex decongestive therapy works most effectively. It is recommended for patients not only to maintain physical activity for its many health benefits but also to facilitate muscle pumping to move lymphatic fluid throughout the body. Knowledge of some of the pathophysiologic mechanisms involved in the development of lymphedema is increasing, and it is possible that current modes of treatment of lymphedema will be augmented by molecular therapies in the future.

Protocol for a pilot randomised controlled clinical trial to compare the effectiveness of a graduated three layer straight tubular bandaging system when compared to a standard short stretch compression bandaging system in the management of people with venous ulceration: 3VSS2008

BackgroundThe incidence of venous ulceration is rising with the increasing age of the general population. Venous ulceration represents the most prevalent form of difficult to heal wounds and these problematic wounds require a significant amount of health care resources for treatment. Based on current knowledge multi-layer high compression system is described as the gold standard for treating venous ulcers. However, to date, despite our advances in venous ulcer therapy, no convincing low cost compression therapy studies have been conducted and there are no clear differences in the effectiveness of different types of high compression.Methods/DesignThe trial is designed as a pilot multicentre open label parallel group randomised trial. Male and female participants aged greater than 18 years with a venous ulcer confirmed by clinical assessment will be randomised to either the intervention compression bandage which consists of graduated lengths of 3 layers of elastic tubular compression bandage or to the short stretch inelastic compression bandage (control). The primary objective is to assess the percentage wound reduction from baseline compared to week 12 following randomisation. Randomisation will be allocated via a web based central independent randomisation service (nQuery v7) and stratified by study centre and wound size ≤ 10 cm2 or >10 cm2. Neither participants nor study staff will be blinded to treatment. Outcome assessments will be undertaken by an assessor who is blinded to the randomisation process.DiscussionThe aim of this study is to evaluate the efficacy and safety of two compression bandages; graduated three layer straight tubular bandaging (3L) when compared to standard short stretch (SS) compression bandaging in healing venous ulcers in patients with chronic venous ulceration. The trial investigates the differences in clinical outcomes of two currently accepted ways of treating people with venous ulcers. This study will help answer the question whether the 3L compression system or the SS compression system is associated with better outcomes.Trial RegistrationACTRN12608000599370

The Standard of Care for Lymphedema: Current Concepts and Physiological Considerations

The standard of care for lymphedema encompasses risk reduction, early detection, Phase-I Complete Decongestive Therapy in a clinical setting, and Phase-II Self Management at home. This review discusses these lymphedema treatment components, including relevant physiological aspects that form the basis of treatment and an understanding of which are critical to successful outcomes. Phase-I therapy includes manual lymphatic drainage (MLD), short-stretch compression bandaging, decongestive exercise, skin care, and sometimes intermittent pneumatic compression (IPC). Home management includes many of the same elements, with adaptations for home treatment. Significant to the success of Phase-I and Phase-II care is effective bandaging and lymphatic drainage treatment via manual (MLD) or automated (IPC) processes. Truncal clearance plays a key role in facilitating lymphatic drainage from affected limbs by achieving effective pressure gradients, reducing lymphatic network resistance, and stimulating lymphatic contractility. The transition from Phase-I to Phase-2 presents challenges to patients and clinicians. Poor patient compliance with time-consuming technique dependent-home care regimens contribute to losing gains achieved in the clinic. Ineffective treatment results in complications, including increased pain, reduced range of motion and mobility, increased risk of infection, and other physical and psychological sequelae. The use of an advanced programmable IPC device for lymphedema treatment may support successful home management by addressing some of the home treatment barriers. Device selection requires careful consideration of the mode of action and device functionality. An advanced programmable device that provides truncal and proximal clearance and low applied pressure represents the current choice for such in-home devices.

A randomised controlled trial of a community nursing intervention: improved quality of life and healing for clients with chronic leg ulcers

The negative impact of chronic leg ulcers on quality of life is well documented. The aim of this study was to determine the effectiveness of a new community nursing model of care on quality of life, morale, depression, self-esteem, social support, healing, pain and functional ability of clients with chronic venous leg ulcers. Venous leg ulcers are slow to heal, frequently recur and are associated with pain, restricted mobility and decreased quality of life. Although chronic wound care consumes a large proportion of community nursing time and health care resources, there is little evidence available on the effectiveness of differing models of community care for this population. Randomised controlled trial. We recruited a sample of 67 participants with venous leg ulcers referred for care to a community nursing organisation in Queensland, Australia after obtaining informed consent. Participants were randomised to either the Lindsay Leg Club model of care (n = 34), emphasising socialisation and peer support; or the traditional community nursing model (n = 33) consisting of individual home visits by a registered nurse. Participants in both groups were treated by a core team of nurses using identical research protocols based on short-stretch compression bandage treatment. Data were collected at baseline, 12 and 24 weeks from commencement. Participants who received care under the Leg Club model demonstrated significantly improved outcomes in quality of life (p = 0.014), morale (p < 0.001), self-esteem (p = 0.006), healing (p = 0.004), pain (p = 0.003) and functional ability (p = 0.044). In this sample, the evaluation of the Leg Club model of care shows potential to improve the health and well-being of clients who have chronic leg ulcers. These results suggest further evaluation and implementation of this model is warranted by community health organisations involved in the care of this population.

Use of a nanocrystalline silver dressing on lymphatic ulcers in patients with chronic lymphoedema

A prospective evaluation to explore the effect of treating patients with chronic lower limb lymphoedema and lymphatic ulcers using a nanocrystalline dressing and multilayer bandaging. Ulcers were cleansed and dressed with a nanocrystalline silver dressing, an alginate dressing and a hydrocellular dressing, followed by multilayer short-stretch compression bandages. A digital planimetry system was used to calculate the ulcer surface area. In cases of multiple ulcers, the areas were added together. Eight patients with chronic lower limb lymphoedema plus ulcers were included. Median age was 53.7 years (range 39.2-72.3). Mean ulcer size was 10.5cm2 (range: 0.8-33.8). All ulcers completely healed after one to nine weeks of treatment. This protocol has been effective in healing lymphatic ulcers and was well accepted by patients. There were no adverse effects or withdrawals. Further studies with larger numbers of patients are required to support these results.

Interventions to enhance patient compliance with leg ulcer treatment: a review of the literature

Non-compliance with compression therapy and with leg exercises and leg elevation is a common problem, often reported in patients with venous leg ulceration. Studies on compliance-enhancing interventions and the effectiveness of these interventions in patients with venous leg ulceration were reviewed. MEDLINE, Cochrane, Embase and CINAHL were explored up to April 2005. Reference lists, wound care journals and conference proceedings were searched. Experts and manufacturers of compression systems were contacted. Studies were eligible if they included patients with venous or mixed leg ulcers and reported patient compliance outcome. Twenty studies were included. Most studies describe patient compliance as the extent to which the compression system was worn and/or the extent to which treatment regimen was followed. Self-reporting was the most commonly used method of compliance assessment. There are indications that class III stockings for patients with venous ulcers enhance compliance compared with short stretch compression bandages. No real evidence is found that intermittent pneumatic compression systems improved compliance. There is no well-documented evidence that healthcare system interventions increase compliance. Educational programmes combining cognitive, behavioural and affective components were shown to have a positive effect on leg elevation, but not on compliance with compression therapy. The included studies have a lack of consistency in defining the standard and operationalization of compliance. Patient compliance plays an ancillary role in research. No study has been able to offer an acceptable and well-documented solution to the non-compliance problem. Research might focus on the development of comprehensive compliance-enhancing strategies. A stronger commitment of healthcare providers and society is needed to make progress in this area. The scope of nursing must be expanded to also include the problems experienced by patients with leg ulcers and the improvement of patient compliance.

Randomized Clinical Trial of Four-Layer and Short-Stretch Compression Bandages for Venous Leg Ulcers (VenUS I)

Randomized Clinical Trial of Four-Layer and Short-Stretch Compression Bandages for Venous Leg Ulcers (VenUS I)

Evaluation of SurePress Comfort: a new compression system for the management of venous leg ulcers

The primary aim was to compare the healing of venous leg ulcers after management with either a new compression stocking (SurePress Comfort, ConvaTec) or a standard short-stretch bandage system (Comprilan, BSN Medical GmbH & Co). Secondary parameters included healing rate, ease of application and removal, comfort during wear, local pain levels and concordance. This was a prospective multicentre open-label comparative randomised controlled parallel-group pilot trial of 12 weeks' duration. The proportion of ulcers that healed in 12 weeks (44.4% versus 17.2%, p=0.027) and the average time to healing (72 +/- 5 days versus 101 +/- 7 days, p=0.0265) were significantly better with SurePress Comfort than the comparator. All the secondary parameters (except concordance) also showed statistically significant differences for the stocking over the comparator. SurePress Comfort stocking system is more effective than a standard short-stretch compression bandage in healing venous leg ulcers and in reducing associated pain. It is well accepted by patients due to its ease of use and comfort, and its safety profile is comparable to that of a standard compression system. It may therefore provide an effective solution for the delivery of graduated compression and has the potential to improve concordance, compared with short- stretch bandages. This study was sponsored by ConvaTec.