Comparative Clinical Study of Four Compressive Therapies for Lower Limb Venous Ulcer

Abstract

Objective: To compare among four types of compression therapy (compression stockings; layered bandages; Unna's boot, and intermittent pneumatic compression) in the treatment of chronic venous ulcers of the lower limbs. Materials/Methods: This was a prospective interventional clinical study with a 12-weeks follow-up, conducted at the Vascular Surgery Service of São Paulo Hospital, Muriaé - MG, approved by the CEP/SCBH, CAAE 49711121.0.0000.5138. Results: Comparison of demographic characteristics and ulcer duration (in months) in relation to the four types of treatments used showed that age (years), BMI, and ulcer duration (months) did not present significant differences among the various treatments assessed. In the study, male patients were more commonly associated with the use of layered and stocking dressings, while female patients predominated in groups treated with Unna's boot and pneumatic compression, and it was statistically significant with a p-value of 0.045. Only smoking showed a significant difference (p<0.05), demonstrating that patients who used stockings and layered dressings smoked proportionally more (37.1% and 41.2%) compared to those who used Unna's boot or pneumatic (17.6% and 16.7%, respectively). There was no significant difference between the types of treatment and the Ulcer Healing Index and the variation from 6 to 12 weeks; there was no significant difference between the types of dressings and the Slough to Granulation Ratio (6 and 12 weeks and variation from 6 to 12 weeks), and between the Gilman index and the different types of dressings used. Compression is the gold standard in the treatment of venous ulcers to promote their healing. However, the results of this study demonstrate that there was no significant difference among the four types of compressive therapy for the treatment of chronic venous ulcers. Conclusion: It was not possible to determine an ideal pressure range in relation to the variables studied, but compression therapy is highly recommended for venous ulcers.