An impressive therapeutic result of class III compression stockings in a patient with longstanding, extensive, combined leg ulcers

Low-grade elastic compression regimen for venous leg ulcers--an effective compromise for patients requiring daily dressing changes

Venous leg ulcers (VLUs) affect millions of patients worldwide and are a tremendous financial burden on our health care system. The hallmark of venous disease of the lower extremities is venous hypertension, and compression is the current mainstay of treatment. However, many patients are non-compliant, partly because of the complexity of the dressings and the difficulties with application and removal. The aim of our study was to test an effective compression dressing regimen for patients with VLUs who require changing the ulcer primary dressing twice daily. We used two layers of a latex-free tubular elastic bandage for compression. The primary endpoint of our study was increased wound-healing rate and our secondary endpoint was complete wound closure. All active study subjects had positive healing rates at week 4 and week 8. Two subjects achieved complete wound closure by week 8. We conclude that compression with a latex-free tubular elastic bandage can be safely used in patients with VLUs requiring frequent dressing changes. This type of compression allows for daily inspection of wounds, dressing changes at home, flexibility in the context of clinical trials, and is a compromise for patients who are intolerant to compression dressings.

Compliance with science: benefits of developing community leg clubs

As a district nurse providing leg ulcer management in a rural community, the author was aware that the effectiveness of compression therapy was, in many cases, compromised by poor compliance to treatment. Once the author had researched the underlying causes of non-compliance, she addressed the issues by developing innovative leg ulcer clinics ('Leg Clubs') to provide holistic care in an environment of patient empowerment, destigmatization and peer support. Analysis of data acquired over an 11-month period illustrates that this new approach has yielded significant reductions in the incidence of non-compliance, allowing the benefits of compression therapy to be realized.