Compression treatment of chronic venous ulceration: A review

G. L. Moneta, A. D. Nicoloff, J. M. Porter

    Research output: Contribution to journalArticle

    12 Scopus citations

    Abstract

    Objective: To review the recent medical literature with regard to the use of compressive therapy in healing and preventing the recurrence of venous ulceration. Methods: Searches of Medline and Embase medical literature databases. Appropriate non-indexed journals and textbooks were also reviewed. Synthesis: Elastic compression therapy is regarded as the 'gold standard' treatment for venous ulceration. The benefits of elastic compression therapy in the treatment of venous ulceration may be mediated through favourable alterations in venous haemodynamics, microcirculatory haemodynamics and/or improvement in subcutaneous Starling forces. Available data indicate compressive therapy is highly effective in healing of the large majority of venous ulcers. Elastic compression stockings, Unna boots, as well as multi-layer elastic wraps, have all been noted to achieve excellent healing rates for venous ulcers. In compliant patients it appears that approximately 75% of venous ulcers can be healed by 6 months, and up to 90% by 1 year. Non-healing of venous ulcers is associated with lack of patient compliance with treatment, large and long-standing venous ulceration and the coexistence of arterial insufficiency. Recurrence of venous ulceration is, however, a significant problem after healing with compressive therapy, even in compliant patients; approximately 20-30% of venous ulcers will recur by 2 years. Conclusions: Compressive therapy is capable of achieving high rates of healing of venous ulceration in compliant patients. Various forms of compression, including elastic, rigid and multi-layer dressings, are available depending on physician preference, the clinical situation and the needs of the individual patient. Compressive therapy, while effective, remains far from ideal. The future goals are to achieve faster healing of venous ulceration, less painful healing and freedom from ulcer recurrence.

    Original languageEnglish (US)
    Pages (from-to)162-168
    Number of pages7
    JournalPhlebology
    Volume15
    Issue number3-4
    DOIs
    StatePublished - Dec 1 2000

    Keywords

    • Compression therapy
    • Elastic stockings
    • Unna boot
    • Venous insufficiency
    • Venous ulcer

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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