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Meta-Analysis
. 2014 May 12;2014(5):CD001899.
doi: 10.1002/14651858.CD001899.pub4.

Intermittent pneumatic compression for treating venous leg ulcers

E Andrea Nelson  1 , Alex Hillman, Kate Thomas
Affiliations
Meta-Analysis

Intermittent pneumatic compression for treating venous leg ulcers

E Andrea Nelson et al. Cochrane Database Syst Rev. .

Abstract

Background: Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs that can be used to treat venous leg ulcers and limb swelling due to lymphoedema.

Objectives: To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients.

Search methods: In April 2014, for this third update, we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.

Selection criteria: We included randomised controlled trials (RCTs) that compared the effects of IPC with control (sham IPC or no IPC) or made comparisons between IPC treatment regimens, in venous ulcer management.

Data collection and analysis: Two review authors reviewed titles and abstracts and agreed on full studies to be retrieved. One review author extracted data and assessed studies for risk of bias and this was checked by a second review author.

Main results: We identified nine randomised controlled trials (including 489 people in total). Only one trial was at low risk of bias overall having reported adequate randomisation, allocation concealment and blinded outcome assessment. In one trial (80 people) more ulcers healed with IPC than with dressings (62% vs 28%; p=0.002). Five trials compared IPC plus compression with compression alone. Two of these (97 people) found increased ulcer healing with IPC plus compression than with compression alone. The remaining three trials (122 people) found no evidence of a benefit for IPC plus compression compared with compression alone.Two trials (86 people) found no difference between IPC (without additional compression) and compression bandages alone.One trial (104 people) compared different ways of delivering IPC and found that rapid IPC healed more ulcers than slow IPC (86% vs 61%).

Authors' conclusions: IPC may increase healing compared with no compression. It is unclear whether it can be used instead of compression bandages. There is some limited evidence that IPC may improve healing when added to compression bandages. Rapid IPC was better than slow IPC in one trial. Further trials are required to determine the reliability of current evidence, which patients may benefit from IPC in addition to compression bandages, and the optimum treatment regimen.

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Conflict of interest statement

None

Figures

1
1
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 IPC plus dressings versus dressings alone, Outcome 1 Number healed in trial.
2.1
2.1. Analysis
Comparison 2 IPC plus compression versus compression alone, Outcome 1 Number healed in trial.
2.2
2.2. Analysis
Comparison 2 IPC plus compression versus compression alone, Outcome 2 Pain at 6 weeks.
3.1
3.1. Analysis
Comparison 3 IPC plus compression versus compression alone ‐ sensitivity analysis, Outcome 1 Number healed in trial.
3.2
3.2. Analysis
Comparison 3 IPC plus compression versus compression alone ‐ sensitivity analysis, Outcome 2 Rate of healing.
4.1
4.1. Analysis
Comparison 4 IPC versus compression (bandage or stocking), Outcome 1 Number healed in trial.
5.1
5.1. Analysis
Comparison 5 Fast IPC versus Slow IPC, Outcome 1 Number healed in trial.
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References

References to studies included in this review

Alvarez 2012 {published data only}
    1. Alvarez O, Wendelken M, Markowitz L, Parker R, Comfort C. Effectiveness of Intermittent Pneumatic Compression for the Treatment of Venous Ulcers in Subjects with Secondary (Acquired) Lymphedema. Vein 2012;5(1):32‐34.
    1. Alvarez OM, Lullove EJ, Wendelken M, Colon‐Cavallito K, Chrzanowski G. Healing Rates and Clinical Benefits of Intermittent Pneumatic Compression (IPC) Therapy in Patients with Chronic Venous Ulcers: Results of a Randomized Controlled Trial in a Single Center and a Retrospective Analysis in 2 Clinical Centers. International Compression Club Meeting. 2013, 8th September.
Coleridge Smith 1989 {published data only}
    1. Coleridge Smith P, Sarin S, Hasty J, Scurr JH. Improved venous ulcer healing using intermittent pneumatic compression. Phlebologie 1988;41(4):788‐9.
    1. Coleridge Smith P, Sarin S, Hasty J, Scurr JH. Sequential gradient pneumatic compression enhances venous ulcer healing: a randomized trial. Surgery 1990;108(5):871‐5. - PubMed
    1. Coleridge Smith PD, Sarin SA, Wilson LAA, Scurr JH. Intermittent pneumatic compression improves venous ulcer healing. Phlebologie '89. Paris: John Libbey Eurotext, 1989:1146‐8.
Dolibog 2013 {published and unpublished data}
    1. Dolibog P, Franek A, Taradaj J, Polak A, Dolibog, P, Blaszczak E, et al. A randomized, Controlled Clinical Pilot study Comparing three types of Compression therapy to treat Venous Leg ulcers in Patients with superficial and/or segmental deep Venous reflux. Ostotomy/Wound Management 2013;59(8):22‐30. - PubMed
Kumar 2002 {published data only}
    1. Kumar S, Samraj K, Nirujogi V, Budnik J, Walker MA. Intermittent pneumatic compression as an adjuvant therapy in venous ulcer disease. Journal of Tissue Viability 2002;12(2):42‐50. - PubMed
    1. Kumar S, Walker A, Gates S, Walker M. Intermittent pneumatic compression as an adjuvant therapy in venous ulcer disease: a randomised trial. Phlebology 2001;16(1):48‐9. - PubMed
McCulloch 1994 {published data only}
    1. McCulloch JM, Marler KC, Neal MB, Phifer TJ. Intermittent pneumatic compression improves venous ulcer healing. Advances in Wound Care 1994;7(4):22‐6. - PubMed
Nikolovska 2002 {unpublished data only}
    1. Nikolovska S, Pavlova LJ, Petrova N, Gocev G. The efficacy of intermittent pneumatic compression in the treatment of venous leg ulcers. Macedonia Medical Review 2002;5:56‐9.
Nikolovska 2005 {published data only}
    1. Nikolovska S, Arsovski A, Damevska K, Gocev G, Pavlova L. Evaluation of two different intermittent pneumatic compression cycle settings in the healing of venous ulcers: a randomized trial. Medical Science Monitor 2005;11:337‐43. - PubMed
Rowland 2000 {published and unpublished data}
    1. Rowland J. Intermittent pneumatic compression versus compression bandages in the treatment of venous leg ulcers. Australian and New Zealand Journal of Surgery 2000;70(2):110‐3. - PubMed
Schuler 1996 {published data only}
    1. Schuler JJ, Maibenco T, Megerman J, Ware M, Montalvo J. Treatment of chronic venous ulcers using sequential gradient intermittent pneumatic compression. Phlebology 1996;11(3):111‐6.

References to studies excluded from this review

Alpagut 2005 {published data only}
    1. Alpagut U, Dayioglu E. Importance and advantages of intermittent external pneumatic compression therapy in venous stasis ulceration. Angiology 2005;56(1):19‐23. - PubMed
Anderson 2006 {published data only}
    1. Anderson I. Venous leg ulcers: methods and devices in compression therapy. Nurse Prescribing 2006;4(6):224‐9.
Bamigboye 2006 {published data only}
    1. Bamigboye AA, Hofmeyr GJ. Interventions for leg edema and varicosities in pregnancy. What evidence?. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2006;129(1):3‐8. - PubMed
Belcaro 1986 {published data only}
    1. Belcaro G, Coen F. Pneumatic intermittent compression treatment of venous ulcerations caused by chronic venous hypertension. Phlebology '85. London: Libbey, 1986:640‐2.
Bolton 2005 {published data only}
    1. Bolton LL. Evidence corner. Comparing a tubular compression device with a short‐stretch bandage. A Compendium of Clinical Research and Practice 2005;17(6):A24, A26.
Delis 2002 {published data only}
    1. Delis KT, Husmann MJ, Nicolaides AN, Wolfe JH, Cheshire NJ. Enhancing foot skin blood flux in peripheral vascular disease using intermittent pneumatic compression: controlled study on claudicants and grafted arteriopaths. World Journal of Surgery 2002;26(7):861‐6. - PubMed
Fassiadis 2005 {published data only}
    1. Fassiadis N. Patient compliance with venous leg ulcer treatment. Phlebolymphology 2005;48:355‐8.
Fogh 2006 {published data only}
    1. Fogh K, Hansson C. News in the treatment of venous leg ulcers. Forum for Nordic Dermato‐Venerology 2006;11(1):14‐8.
Gale 2004 {published data only}
    1. Gale SS, Shuman S, Beebe HG, Pigott JP, Comerota AJ. Percutaneous venous valve bioprosthesis: Initial observations. Vascular and Endovascular Surgery 2004;38(3):221‐4. - PubMed
Grieveson 2003 {published data only}
    1. Grieveson S. Intermittent pneumatic compression pump settings for the optimum reduction of oedema. Journal of Tissue Viability 2003;13(3):98‐104. - PubMed
Junger 2004 {published data only}
    1. Junger M, Partsch H, Ramelet A, Zuccarelli F. Efficacy of a ready‐made tubular compression device versus short‐stretch compression bandages in the treatment of venous leg ulcers. Wounds ‐ A Compendium of Clinical Research and Practice 2004;16(10):313‐20.
    1. Junger M, Partsch H, Ramelet AA, Zuccarelli F. Efficacy of a new compression device versus bandages in the treatment of venous leg ulcers. 2nd World Union of Wound Healing Societies' Meeting, Paris. 2004:11.
Kakkos 2005 {published data only}
    1. Kakkos SK, Griffin M, Geroulakos G, Nicolaides AN. The efficacy of a new portable sequential compression device (SCD Express) in preventing venous stasis. Journal of Vascular Surgery 2005;42(2):296‐303. - PubMed
Kalodiki 2007 {published data only}
    1. Kalodiki E. Use of intermittent pneumatic compression in the treatment of venous ulcers. Future Cardiology 2007;3(2):185‐91. - PubMed
    1. Kalodiki E, Ellis M, Kakkos SK, Williams A, Davies AH, Geroulakos G. Immediate hemodynamic effect of the additional use of the SCD EXPRESS compression system in patients with venous ulcers treated with the four‐layer compression bandaging system. European Journal of Vascular and Endovascular Surgery 2007;33(4):483‐7. - PubMed
Kolbach 2006 {published data only}
    1. Kolbach DN, Sandbrink MWC, Neumann HAM, Prins MH. Compression therapy for treating stage I and II (Widmer) post‐thrombotic syndrome. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD004177] - DOI - PubMed
Kussmann 2005 {published data only}
    1. Kussmann KS. Intermittent pneumatic compression therapy ‐ 'Pro'. Lymphologie in Forschung und Praxis 2005;9(2):107‐8.
Murakami 2003 {published data only}
    1. Murakami M, McDill TL, Cindrick‐Pounds L, Loran DB, Woodside KJ, Mileski WJ, et al. Deep venous thrombosis prophylaxis in trauma: improved compliance with a novel miniaturized pneumatic compression device. Journal of Vascular Surgery 2003;38(5):923‐7. - PubMed
Omar 2004 {published data only}
    1. Omar AA, Mavor AID, Jones AM, Homer‐Vanniasinkam S. Treatment of venous leg ulcers with Dermagraft. European Journal of Vascular and Endovascular Surgery 2004;27(6):666‐72. - PubMed
Partsch 2006 {published data only}
    1. Partsch H. Compression therapy of venous ulcers: haemodynamic effects depend on interface pressure and stiffness. EWMA Journal 2006;6(2):16‐20.
Pekenmaki 1987 {published data only}
    1. Pekanmaki K, Kolari PJ, Kiistala U. Intermittent pneumatic compression treatment for post‐thrombotic leg ulcers. Clinical and Experimental Dermatology 1987;12:350‐3. - PubMed
Rajendran 2007 {published data only}
    1. Rajendran S, Rigby AJ, Anand SC. Venous leg ulcer treatment and practice‐‐Part 3 The use of compression therapy systems. Journal of Wound Care 2007;16(3):107‐9. - PubMed
Robson 2006 {published data only}
    1. Robson MC, Cooper DM, Aslam R, Gould LJ, Harding KG, Margolis DJ, et al. Guidelines for the treatment of venous ulcers. Wound Repair and Regeneration 2006;14(6):649‐62. - PubMed
Rudicel 2001 {published data only}
    1. Rudicel S. Intermittent pneumatic compression promoted healing in foot infections. Journal of Bone and Joint Surgery. American Volume 2001;83‐A(5):787. - PubMed
Scheur 1999 {published data only}
    1. Scheur van de MR, Kessels F, Sommer A, et al. Intermittent pneumatic compression as alternative for compressive bandages in the out patient management of venous ulceration and venous oedema. A pilot study in cost‐minimisation. Scripta Phlebologica 1999;7:3‐6.
Sottiurai 1990 {published data only}
    1. Sottiurai VS. Comparison of surgical modalities in the treatment of recurrent venous ulcer. International Angiology 1990;9(4):231‐5. - PubMed
Stephen 2006 {published data only}
    1. Stephen‐Haynes J, Lindsay E, Muldoon J. Easing compression hosiery application: ActiGlide. British Journal of Community Nursing 2006;11(9):S21‐2. - PubMed
Trzeciak 2004 {published data only}
    1. Trzeciak S, Dellinger RP. Other supportive therapies in sepsis: an evidence‐based review. Critical Care Medicine 2004;32(11):S571‐7. - PubMed
Wang 2007 {published data only}
    1. Wang SM, Yao C. Diagnosis and treatment of chronic venous ulcer: Research status and new strategies. Acta Academiae Medicinae Sinicae 2007;29(1):5‐8. - PubMed
Wienert 2005 {published data only}
    1. Wienert V, Partsch H, Gallenkemper G, Gerlach H, Junger M, Marschall M, et al. Guideline: Intermittent pneumatic compression. Phlebologie 2005;34(3):176‐80.

Additional references

Callam 1985
    1. Callam MJ, Ruckley CV, Harper DR, Dale JJ. Chronic leg ulceration: the extent of the problem and the provision of care. BMJ 1985;290:1855‐6. - PMC - PubMed
Cullum 1997
    1. Cullum N, Fletcher A, Semlyen A, Sheldon TA. Compression therapy for venous leg ulcers. Quality in Health Care 1997;6:226‐31. - PMC - PubMed
Higgins 2003
    1. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analysis. BMJ 2003;327(7414):557‐60. - PMC - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, on behalf of the Cochrane Statistical Methods Group and the Cochrane Bias Methods Group (Editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J, on behalf of the Cochrane Information Retrieval Methods Group. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.orgg.

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