Comment

As with many of the so-called adjunctive therapies for venous ulcers, there is little literature on the effectiveness of intermittent pneumatic compression. It certainly seems that intermittent pneumatic compression may be beneficial as an adjunct to standard limb compression, but this has yet to be demonstrated conclusively. The largest study, of 45 patients, did demonstrate a benefit, but the standard compression used was graduated compression stockings, in contrast to the Unna boot used in another study that failed to show a significant difference in the proportion of ulcers healed after 6 months.41 Of note, both studies demonstrated an increase in the actual rate of healing, suggesting that the different study endpoints (3 versus 6 months) may have played a role in the differing results.

It is therefore possible that intermittent pneumatic compression could be an effective adjunct to standard compression, but further study - ideally a large randomised controlled trial with a meticulous protocol - is needed before this can be known conclusively. Moreover, it is important to explore whether intermittent pneumatic compression would result in a slightly more rapid healing of wounds already destined to heal within a several-month period, or whether it could potentially increase the likelihood of wounds healing that would otherwise fail to heal after months of therapy.

The size of the equipment means that the patient must remain in a single place for the duration of therapy. The equipment is also costly.

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