title: Randomized clinical trial of four-layer and short-stretch compression bandages for venous leg ulcers (VenUS I).
abstract: BACKGROUND
  A randomized clinical trial was undertaken to determine the relative effectiveness of four-layer and short-stretch bandaging for venous ulceration.
  
  
  METHODS
  A total of 387 adults with a venous ulcer, who were receiving leg ulcer treatment either in primary care or as a hospital outpatient, were recruited to this parallel-group open study and randomized to either four-layer or short-stretch bandages. Follow-up continued until the patient's reference leg was ulcer free or for a minimum of 12 months. The primary endpoint was time to complete healing of all ulcers on the reference leg. Secondary outcomes included proportion of ulcers healed, health-related quality of life, withdrawals and adverse events. Analysis was by intention to treat.
  
  
  RESULTS
  Unadjusted analysis identified no statistically significant difference in median time to healing: 92 days for four-layer and 126 days for short-stretch bandages. However, when prognostic factors were included in a Cox proportional hazards regression model, ulcers treated with the short-stretch bandage had a lower probability of healing than those treated with the four-layer bandage: hazard ratio 0.72 (95 per cent confidence interval 0.57 to 0.91). More adverse events and withdrawals were reported with the short-stretch bandage.
  
  
  CONCLUSIONS
  Venous leg ulcers treated using a four-layer bandage healed more quickly than those treated with a short-stretch bandage.
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building (Area 4), University of York, Heslington, York YO10 5DD, UK.
authors.forename: E A
authors.initials: EA
authors.lastname: Nelson
authors.forename: C P
authors.initials: CP
authors.lastname: Iglesias
authors.forename: N
authors.initials: N
authors.lastname: Cullum
authors.forename: D J
authors.initials: DJ
authors.lastname: Torgerson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000534:rehabilitation*; D014945:Wound Healing