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.

The audit as published in the Journal of Wound Care


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 VLUShi 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: 

Andriessen A, Apelqvist J, Mosti G, Partsch H, Gonska C, Abel M. Compression therapy for venous leg ulcers: risk factors for adverse events and complications, contraindications – a review of present guidelines. J Eur Acad Dermatol Venereol. 2017 Sep;31(9):1562-1568. doi: 10.1111/jdv.14390. Epub 2017 Jul 31. PMID: 28602045.

Rabe, E., Partsch, H., Morrison, N., Meissner, M. H., Mosti, G., Lattimer, C. R., Carpentier, P. H., Gaillard, S., Jünger, M., Urbanek, T., Hafner, J., Patel, M., Wu, S., Caprini, J., Lurie, F., & Hirsch, T. (2020). Risks and contraindications of medical compression treatment – A critical reappraisal. An international consensus statement. Phlebology, 35(7), 447–460. https://doi.org/10.1177/0268355520909066

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 pharmacyOusey 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

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