Is High Compression Hosiery Necessary for Preventing Recurrence of Venous Ulcers?

Studies indicate that about one percent of adults will suffer from leg ulceration at some time in their lives. The majority of these leg ulcers are the result of high pressure in the veins, usually due to a blockage in the veins or weakness within the valves in the leg that prevent the backflow of blood into the leg as that blood is normally pumped out by the action of the calf muscles as we walk.

While surgery is sometimes used to treat venous ulcers by repairing or removing the veins, in the majority of cases compression bandages are used to treat the ulcers. Once healed, the use of compression hosiery is usually recommended to prevent the recurrence of such ulcers.

Study Objective:

This study reviewed a number of randomized, controlled research trials that evaluated the benefits of compression bandages or hosiery for prevention of venous leg ulcers.

Main Results:

This study found one trial of 300 patients that compared the results of high compression hosiery with moderate compression hosiery in preventing the recurrence of venous ulcers over a five year period. While the trial seemed to indicate no significant reduction in ulcer recurrence as the result of wearing the higher compression hosiery, the trial found that compliance rates were significantly higher in those wearing the medium compression hosiery and that many of the trial patients switched from the high compression to moderate compression hosiery during the trial.

Main Conclusions:

Although the trials reviewed did not compare compression versus no compression for the prevention of ulcer recurrence, not wearing compression hosiery was associated with higher incidence levels of ulcer recurrence in both main trials reviewed. The study reviewers found circumstantial evidence for the benefit of compression in reducing ulcer recurrence.

They also found evidence that recurrence rates may be lower when higher compression hosiery was used. Their recommendation was that the strongest level of compression hosiery that could be tolerated be used by patients seeking to prevent recurrence of venous ulcers.