The certainty of the evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding).
Compression is recommended for preventing recurrence of venous ulcers.
The recommendation is strong because potential benefits of the intervention clearly exceed plausible harms.
A Cochrane review [Abstract] 1 included 8 studies with a total of 1 995 subjects with healed venous ulcers. Most participants were women, and the average age ranged from 58 years to 78 years. The studies used different levels of compression and no compression. No studies compared different lengths of compression (e.g. below-knee compared with above-knee). Duration of follow-up ranged from 6 months to 10 years. .
EU class 3 compression stockings reduced reulceration compared with no compression over 6 months (RR 0.46, 95% CI 0.27 to 0.76; 1 study, n=153).EU class 1 compression stockings compared with EU class 2 compression stockings had no difference on reulceration over 12 months (RR 1.70, 95% CI 0.67 to 4.32; 1 study, n=99). There was no difference in rates of noncompliance over 12 months between EU class 1 stockings and EU class 2 stockings (RR 1.22, 95% CI 0.40 to 3.75; 1 study, n=99).
UK class 2 hosiery compared with UK class 3 hosiery was associated with a higher risk of reulceration over 18 months to 10 years (RR 1.55, 95% CI 1.26 to 1.91; 5 studies, n=1 314). People who used UK class 2 hosiery were more compliant with compression treatment than people who used UK class 3 hosiery over 18 months to 10 years (RR for noncompliance 0.69, 95% CI 0.49 to 0.99; 5 studies, n=1 372).
There was no difference between Scholl UK class 2 compression stockings and Medi UK class 2 compression stockings in terms of reulceration (RR 0.77, 95% CI 0.47 to 1.28; 1 study, n=166) and noncompliance (RR 0.97, 95% CI 0.84.1 to 12; 1 study, n=166) over 18 months.
Primary/Secondary Keywords