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Randomized Controlled Trial
. 2013 Dec 14;11(1):34-43.
doi: 10.7150/ijms.7548. eCollection 2014.

A comparative clinical study on five types of compression therapy in patients with venous leg ulcers

Pawel Dolibog  1 , Andrzej Franek  1 , Jakub Taradaj  2 , Patrycja Dolibog  1 , Edward Blaszczak  1 , Anna Polak  3 , Ligia Brzezinska-Wcislo  4 , Antoni Hrycek  5 , Tomasz Urbanek  6 , Jacek Ziaja  7 , Magdalena Kolanko  4
Affiliations
Randomized Controlled Trial

A comparative clinical study on five types of compression therapy in patients with venous leg ulcers

Pawel Dolibog et al. Int J Med Sci. .

Abstract

The aim of this study was to compare five types of compression therapy in venous leg ulcers (intermittent pneumatic vs. stockings vs. multi layer vs. two layer short stretch bandages vs. Unna boots). Primary study endpoints were analysis of changes of the total ulcer surface area, volume and linear dimensions inside observed groups. The secondary end points were comparisons between all groups the number of completely healed wounds (ulcer healing rates), Gilman index and percentage change of ulcer surface area. In total, 147 patients with unilateral venous leg ulcers were included to this study. Participants were randomly allocated to the groups: A, B, C, D and E. After two months the healing rate was the highest in group A (intermittent pneumatic compression) - 57.14%, 16/28 patients, B (ulcer stocking system) - 56.66%, 17/30 patients and C (multi layer short stretch bandage) - 58.62%, 17/29 patients. Significantly much worse rate found in group D (two layer short stretch bandages) - only 16.66%, 5/30 patients and E (Unna boots) - 20%, 6/30 patients. The analysis of changes of the percentage of Gilman index and wound total surface area confirmed that intermittent pneumatic compression, stockings and multi layer bandages are the most efficient. The two layer short - stretch bandages and Unna boots appeared again much less effective.

Keywords: Unna boots; compression stockings; short stretch bandages; venous leg ulcers; wound healing.

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Conflict of interest statement

Competing Interests: The authors would like to certify that have no commercial associations with the manufacturers of the equipment described in the manuscript and other conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram through the study
Figure 2
Figure 2
Comparison between groups in terms of healing rate. *Fisher test. Legends: - groups A and D (57.14% vs. 16.66%, P=0.03), - groups B and D (56.66% vs.16.66%, P=0.03), - groups C and D (58.62% vs. 16.66%, P=0.03), - groups A and E (57.14% vs. 20.00%, P=0.03), - groups B and E (56.66% vs.20.00%, P=0.03), - groups C and E (58.62% vs. 20.00%, P=0.03).
Figure 3
Figure 3
Comparison between groups in terms of Gilman index [cm]. * the Kruskal-Wallis analysis. Legends: - groups A and D (0.52 cm vs. 0.20 cm, P=0.04), - groups B and D (0.49 cm vs. 0.20 cm, P=0.04), - groups C and D (0.51 cm vs. 0.20 cm, P=0.04), - groups A and E (0.52 cm vs. 0.23 cm, P=0.04), - groups B and E (0.49 cm vs. 0.23 cm, P=0.04), - groups C and E (0.51 cm vs. 0.23 cm, P=0.04).
Figure 4
Figure 4
Comparison between groups in terms of change of the percentage ulcer size. * the Kruskal-Wallis analysis. Legends: - groups A and D (48.11% vs. 17.77%, P=0.04), - groups B and D (41.22% vs. 17.77%, P=0.04), - groups C and D (49.02% vs. 17.77%, P=0.04), - groups A and E (48.11% vs. 20.48%, P=0.04), - groups B and E (41.22% vs. 20.48%, P=0.04), - groups C and E (49.02% vs. 20.48%, P=0.04).
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