title: The clinical effectiveness of two compression stocking treatments on venous leg ulcer recurrence: a randomized controlled trial.
abstract: Venous leg ulcers affect up to 3% of people aged 65 years and older, present significant pain and suffering, and are associated with long episodes of health care. These chronic wounds recur at rates of up to 69%. A double blind randomized controlled trial was conducted in a home nursing setting in Victoria, Australia to compare the effectiveness of a 23 to 32 mm Hg (moderate) and a 34 to 46 mm Hg (high) compression stocking treatment on venous ulcer recurrence. Participants (n = 100) were monitored for 26 weeks. Study wound recurrence was low (11.8%), and the average time to recurrence was 77.91 days. Adherence to treatment was low (44%) with nonadherence significantly higher in the high-compression stocking group, χ(2)(1) = 8.827, P = .003. Regression modeling found that adherence to treatment significantly predicted study wound recurrence, Wald(1) = 7.917, P = .005. Estimated hazard ratios showed that participants who did not adhere were 9 times more likely to have their wound recur. Risk of recurrence was 3 times greater for those randomized to moderate compression when compared with the high-compression stocking. Implementing strategies that optimize adherence to compression will reduce ulcer recurrence. Once this has been realized, the potential to adhere to high-compression treatment would further reduce the risk of recurrence.
authors.affiliation: 1RDNS Institute, St Kilda, Victoria, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Kapp
authors.forename: Charne
authors.initials: C
authors.lastname: Miller
authors.forename: Lisa
authors.initials: L
authors.lastname: Donohue
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D053828:Stockings, Compression / Q000191:economics*; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000191:economics / Q000628:therapy*; D014945:Wound Healing
keywords: adherence; compression stocking; randomized controlled trial; recurrence; venous leg ulcer