Stockings before bandages: An option for venous ulcers

摘要

In The Lancet, Rebecca Ashby and colleagues1 report the results of a large pragmatic trial of a treatment for venous leg ulcers, in which they compare new two-layer compression hosiery with four-layer compression bandages, which are regarded as the standard care for venous leg ulcers. The investigators recorded no difference in the number of patients healed, and no difference in the trial's primary endpoint, median time to healing, between the two treatment groups—99 days (95% Cl 84-126) with hosiery and 98 days (85-112) with compression bandages. Additionally, patients randomly allocated to hosiery had less ulcer recurrence, an improved quality of life, and reduced costs as compared with those in the bandage group. These findings have the potential to change clinical recommendations for care of venous leg ulcers, so we believe that further exploration of this topic and the study is worthwhile.