Adaptive compression therapy for venous leg ulcers: a clinically effective, patient‐centred approach. Issue 3 (7th May 2014) - Harding, Keith G
Abstract: A prospective, randomised, 12‐week study was performed to evaluate the efficacy and tolerability of two compression methods for venous leg ulcers (VLUs); a new adaptive compression therapy (ACT) system, combining intermittent and sustained pneumatic compression ( n = 38) and a conventional four‐layer bandage system ( n = 52). Primary outcomes were ulcer healing and safety. Secondary outcomes were comfort, compliance, ulcer pain, patient‐perceived product performance and quality of life. Ulcer healing rate was similar (31·6% versus 42·3%, respectively, P = 0·30) between the treatments. Adverse events and patient‐rated comfort were also similar. Average daily usage for the dual system was 10·5 and 1·8 hours in the sustained and intermittent modes, respectively, representing its use during 71% of waking hours. Predicted final ulcer pain was also similar ( P = 0·68). Performance was subjectively better for adaptive compression and significantly higher for exudate management ( P = 0·04), skin protection ( P < 0·001), removal ease ( P = 0·0007), bathing ( P < 0·0001) and sleep comfort ( P = 0·0405). The adjusted final quality‐of‐life score was 0·1025 higher for adaptive compression ( P = 0·0375). Subjects with healed ulcers attained higher final scores than unhealed subjects ( P = 0·0004). This study provides evidence that ACT is comparably efficacious to successfully heal VLUs compared with four‐layer bandage management but is better accepted and achieves higher patient‐reported quality‐of‐life scores in these challenging patients.