title: Protocol for a pilot randomised controlled clinical trial to compare the effectiveness of a graduated three layer straight tubular bandaging system when compared to a standard short stretch compression bandaging system in the management of people with venous ulceration: 3VSS2008.
abstract: BACKGROUND
  The incidence of venous ulceration is rising with the increasing age of the general population. Venous ulceration represents the most prevalent form of difficult to heal wounds and these problematic wounds require a significant amount of health care resources for treatment. Based on current knowledge multi-layer high compression system is described as the gold standard for treating venous ulcers. However, to date, despite our advances in venous ulcer therapy, no convincing low cost compression therapy studies have been conducted and there are no clear differences in the effectiveness of different types of high compression.
  
  
  METHODS
  The trial is designed as a pilot multicentre open label parallel group randomised trial. Male and female participants aged greater than 18 years with a venous ulcer confirmed by clinical assessment will be randomised to either the intervention compression bandage which consists of graduated lengths of 3 layers of elastic tubular compression bandage or to the short stretch inelastic compression bandage (control). The primary objective is to assess the percentage wound reduction from baseline compared to week 12 following randomisation. Randomisation will be allocated via a web based central independent randomisation service (nQuery v7) and stratified by study centre and wound size <or= 10 cm2 or >10 cm2. Neither participants nor study staff will be blinded to treatment. Outcome assessments will be undertaken by an assessor who is blinded to the randomisation process.
  
  
  CONCLUSIONS
  The aim of this study is to evaluate the efficacy and safety of two compression bandages; graduated three layer straight tubular bandaging (3L) when compared to standard short stretch (SS) compression bandaging in healing venous ulcers in patients with chronic venous ulceration. The trial investigates the differences in clinical outcomes of two currently accepted ways of treating people with venous ulcers. This study will help answer the question whether the 3L compression system or the SS compression system is associated with better outcomes.
  
  
  BACKGROUND
  ACTRN12608000599370.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Level 3 Burnet Building, The Alfred Hospital, Monash University, Melbourne, Australia. carolina.weller@med.monash.edu.au
authors.forename: Carolina D
authors.initials: CD
authors.lastname: Weller
authors.forename: Sue
authors.initials: S
authors.lastname: Evans
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Reid
authors.forename: Rory
authors.initials: R
authors.lastname: Wolfe
authors.forename: John
authors.initials: J
authors.lastname: McNeil
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011312:Pressure; D012107:Research Design; D053828:Stockings, Compression / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000473:pathology / Q000628:therapy*; D014945:Wound Healing; D055815:Young Adult