Evidence and guidelines
In this section, you can find links to relevant evidence and evidence/best practice guidelines supporting use of compresion therapy in leg ulcer management.
The section will be updated with additional materials!
Published in connection with the EWMA Compression Therapy Campaign
This audit was designed to identify the need of the population and the clinical activity associated with wounds and the management of lower limb swelling. The exploration focused on lower leg wound management, access to diagnostics and compression therapy across each audit site. The audit was carried out in several sites in the UK.
The audit was realised in connection with the EWMA Compression Therapy Programme.
Guidelines & Best practice
The German Phlebology Society (DGP), in cooperation with DDG, DGA, DGG, GDL, DGL, BVP. Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC)
HAS (France), BON USAGE DES TECHNOLOGIES DE SANTÉ (In French): La compression médicale dans les affections veineuses chroniques
Wound Healing Society (US): Wound Healing Society 2015 update on guidelines for venous ulcers. Wound Repair Regen. 2016 Jan-Feb;24(1):136-44. doi: 10.1111/wrr.12394. PMID: 26663616.
Papers/reviews
Guide to compression garment selection for the lower extremity: Bjork R, Ehmann S, S.T.R.I.D.E: Professional guide to compression garment selection for the lower extremity. J Wound Care 2019;1:28(Sup6a):1-44.
Cochrane review – compression vs no compression for VLU: Shi C, Dumville JC, Cullum N, Connaughton E, Norman G. Compression bandages or stockings versus no compression for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2021, Issue 7. Art. No.: CD013397.
About the epidemiology and use of compression therapy: Heyer K, Protz K, Glaeske G, Augustin M. Epidemiology and use of compression treatment in venous leg ulcers: nationwide claims data analysis in Germany. Int WoundJ 2017; 14:338–343
Recent review of evidence (In German): Dissemond, J., Kröger, K. & Stücker, M. Evidenz der Kompressionstherapie unter besonderer Berücksichtigung der medizinischen adaptiven Kompressionssysteme. Hautarzt 71, 301–308 (2020). https://doi.org/10.1007/s00105-020-04554-x
About the need for education and training in compression therapy: Protz K, Dissemond J, Karbe D, Augustin M, Klein TM. Increasing competence in compression therapy for venous leg ulcers through training and exercise measured by a newly developed score-Results of a randomised controlled intervention study. Wound Repair Regen. 2021 Mar;29(2):261-269. doi: 10.1111/wrr.12899. Epub 2021 Feb 18. PMID: 33598997.
About education of patients and their relatives: Protz K, Dissemond J, Seifert M, Hintner M, Temme B, Verheyen-Cronau I, Augustin M, Otten M. Education in people with venous leg ulcers based on a brochure about compression therapy: A quasi-randomised controlled trial. Int Wound J. 2019 Dec; 16(6): 1252-1262.
About the potential risk factors and contraindications:
About the health economy of leg ulcers and leg ulcer diagnosis: Guest JF, Fuller GW, Vowden PCohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013BMJ Open 2020;10:e045253. doi: 10.1136/bmjopen-2020-045253
What to know about compression in the pharmacy: Ousey K, Atkin L, Conway B et al (2021) Compression therapy for pharmacy teams. London: ounds UK. Available to download from: www.wounds-uk.com
About ABI testing and amputation in lower extremity ulcers: Aguirre A et al. Early ABI testing may decrease risk of amputation for patients with lower extremity ulcers. Ann Vasc Surg; 79:65-71
Compression therapy and wound healing: Partsch, Compression for leg wounds, 2015, British Journal of Dermatology, Wiley Online Library
Excerise and compression therapy: Jull A et al. Exercise with compression vs compression alone in treating patienst with venous leg ulcers. A systematic review and meta-analysis. JAMA Dermatol 2018; 154(11):1304-11
