Comment

One study has shown that compression reduces the risk of recurrent venous ulceration. Two studies that compared different types of compression found that non-compliant patients had a higher rate of recurrence than those who

What therapies are effective in reducing the risk of recurrence of venous leg ulcers?

were compliant with any type of compression regimen. While these data may seem to suggest that ulcers may recur in patients who do not use compression, there are other confounding factors that need to be addressed before this conclusion can be drawn. For example, non-compliant patients may be more or less likely to have serious wounds or to comply with other elements of wound care, including nutrition and avoiding trauma.

The findings of the recent trial, coupled with the implications of the non-compliant patients' increased rate of recurrence from earlier trials and the biological plausibility of this therapy mean that compression is likely to reduce the risk of recurrence of venous leg ulcers. Finally, compression therapy to prevent recurrence is considered by most wound care experts to be "standard therapy". It might not be ethically justified to conduct a trial comparing limb compression with no limb compression for prevention of recurrent ulceration.

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