Stockings or bandages for leg-ulcer compression?

Adderley U, Stubbs N (2014) Stockings or bandages for leg-ulcer compression? Nursing Times; 110: 15, 19-20.

Background

Four-layer bandaging is the standard treatment for venous leg ulcers but is bulky and can restrict mobility. Two-layer compression stockings have recently been marketed but their clinical and cost effectiveness were unknown.

Aim

To compare the clinical and cost effectiveness of four-layer bandaging with two-layer compression stockings.

Method

In a pragmatic, open, randomised controlled trial 454 participants were randomly allocated two-layer compression stockings or four-layer bandages and followed for up to 12 months after healing.

Results

The median time to ulcer healing was almost identical (stockings group: 99 days, bandaging group: 98 days). More patients allocated stockings changed treatment but ulcer recurrence rates were higher in the bandaging group. Stockings cost £302 less per participant per year and had more than 95% probability of being the most cost-effective treatment.

Conclusion

Two-layer compression stockings are a viable, cost-effective alternative to four-layer bandaging but may not be suitable for all patients.

• This article has been double-blind peer reviewed

The efficacy of four-layer compression bandaging, seen as the gold standard treatment for venous leg ulcers, was compared with that of two-layer compression stockings

In this article…

• ▸ The rationale behind the comparison study

• ▸ How the study research was conducted

• ▸ Implications for nurses treating venous leg ulcers