title: Randomized clinical trial and economic analysis of four-layer compression bandaging for venous ulcers.
abstract: BACKGROUND
  The aim of this study was to compare the cost-effectiveness of four-layer compression bandaging for venous leg ulcers with that of other available treatments.
  
  
  METHODS
  In this pragmatic trial, 200 patients with a venous leg ulcer were randomized either to four-layer bandaging (intervention group; n = 100) or to continue their usual system of care (control group; n = 100). The follow-up for each patient was 12 weeks. Analysis was by intention to treat; the main outcome measures were time to healing and cost to the health board per leg healed.
  
  
  RESULTS
  Baseline characteristics were well matched in the two groups. The Kaplan-Meier estimate of the healing rate at 3 months was 54 per cent with four-layer bandaging and 34 per cent in the control group. Throughout the 3 months, four-layer bandaging healed leg ulcers significantly earlier (P = 0.006). There was a significant reduction in the median cost per leg healed with four-layer bandaging (euro 210 versus euro 234; P = 0.040).
  
  
  CONCLUSIONS
  Four-layer bandaging is currently the most effective method of treating venous leg ulcers in a community setting.
authors.affiliation: Department of Vascular Surgery, Mid-Western Regional Hospital, Limerick, Ireland.
authors.forename: J F
authors.initials: JF
authors.lastname: O'Brien
authors.forename: P A
authors.initials: PA
authors.lastname: Grace
authors.forename: I J
authors.initials: IJ
authors.lastname: Perry
authors.forename: A
authors.initials: A
authors.lastname: Hannigan
authors.forename: M
authors.initials: M
authors.lastname: Clarke Moloney
authors.forename: P E
authors.initials: PE
authors.lastname: Burke
mesh_terms: D000368:Aged; D001458:Bandages / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources / Q000191:economics; D006801:Humans; D008297:Male; D014647:Varicose Ulcer / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology