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Review
. 2023 Feb;20(2):430-447.
doi: 10.1111/iwj.13891. Epub 2022 Jul 18.

A meta-review of the impact of compression therapy on venous leg ulcer healing

Declan Patton  1   2   3   4   5 , Pinar Avsar  1   2 , Aicha Sayeh  1 , Aglecia Budri  1   2 , Tom O'Connor  1   2   3   4   6 , Simone Walsh  1 , Linda Nugent  1   2   3 , Denis Harkin  7 , Niall O'Brien  8 , Jonathan Cayce  9 , Michael Corcoran  10 , Mario Gaztambide  10 , Zena Moore  1   2   3   4   6   11   12   13   14
Affiliations
Review

A meta-review of the impact of compression therapy on venous leg ulcer healing

Declan Patton et al. Int Wound J. 2023 Feb.

Abstract

This meta-review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR-2 tool was used for quality appraisal and the certainty of the evidence was appraised using GRADEpro. Data analysis was undertaken using RevMan. We identified 12 systematic reviews published between 1997 and 2021. AMSTAR-2 assessment identified three as high quality, five as moderate quality, and four as low quality. Seven comparisons were reported, with a meta-analysis undertaken for five of these comparisons: compression vs no compression (risk ratio [RR]: 1.55; 95% confidence interval [CI] 1.34-1.78; P < .00001; moderate-certainty evidence); elastic compression vs inelastic compression (RR: 1.02; 95% CI: 0.96-1.08; P < .61 moderate-certainty evidence); four layer vs <four-layer bandage systems (RR: 1.07; 95% CI: 0.82-1.40; P < .63; moderate-certainty evidence); comparison between different four-layer bandage systems (RR: 1.08; 95% CI: 0.93-1.25; P = .34; moderate-certainty evidence); compression bandage vs compression stocking (RR 0.95; 95% CI 0.87-1.03; P = .18; moderate-certainty evidence). The main conclusion from this review is that there is a statistically significant difference in healing rates when compression is used compared with no compression, with moderate-certainty evidence. Otherwise, there is no statistically different difference in healing rates using elastic compression vs inelastic compression, four layer vs <four-layer bandage systems, different four-layer bandage systems, or compression bandages vs compression stockings.

Keywords: compression bandages; compression therapy; healing; meta-review; venous leg ulcers.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA 2020 flow diagram for study selection
FIGURE 2
FIGURE 2
Forest plot: Compression vs no compression, outcome: Wound healed. CI, confidence interval
FIGURE 3
FIGURE 3
Forest plot: Elastic compression vs inelastic compression, outcome: Wound healed. CI, confidence interval
FIGURE 4
FIGURE 4
Forest plot: Comparison between four layers vs <4 layer bandage systems, outcome: Wounds healed. CI, confidence interval
FIGURE 5
FIGURE 5
Forest plot: Comparison between different four‐layer bandage systems, outcome: Wounds healed. CI, confidence interval
FIGURE 6
FIGURE 6
Comparison: Compression bandage vs compression stocking, outcome: Wound healed. CI, confidence interval
See this image and copyright information in PMC

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