Compliance to compression therapy in patients with existing venous leg ulcers. Results of a cross-sectional study [Compliance Hinsichtlich der Kompressionstherapie bei Patienten mit Floridem Ulcus Cruris Venosum: Ergebnisse Einer Querschnittsuntersuchung]

摘要

Background and Purpose: Compression therapy is an essential part in the treatment of patients with venous leg ulcers. However, not all patients follow this recommendation. The authors tried to analyze how many patients performed compression therapy at the time of data collection and the reasons for insufficient or missing compression therapy. Patients and Methods: Within a cross-sectional study in 73 patients with venous leg ulcers (patients with epifascial varicosis as well as patients with postthrombotic syndrome), conducted between 11/2007 and 01/2009 in the own specialized wound ambulance, it was documented, if the patients performed compression therapy at all. By clinically defined criteria, the attending doctor evaluated the efficiency of the compression therapy and documented who had been responsible for the compression therapy. Patients not wearing any compression were asked for the reasons. 25 patients were registered several times and evaluated separately; for those, the authors tried to find out, if compliance to compression therapy after refreshing of the recommendation had changed. Results: In total, 75% (n = 55) of 73 patients were performing compression therapy at the time of data collection, most of them with short stretch bandages. In 50% (n = 19), compression therapy was sufficient. Most of these patients (n = 24, 63%) put the bandages on by themselves. If the bandages had been put on inadequately, the patients explained this (multiple answers possible) mostly with unfitting shoes or extreme overweight. In the group of patients with compression stockings, compression therapy was optimal in 91%; the patients put the stockings on by themselves in nearly all cases. 25% of the patients (n = 18) did not perform any compression. In 61% (n = 11), they explained this with their own unwillingness. 25 patients were observed more than once. 15 of them showed an unchanged compression standard in the follow-up, in detail with sufficient compression in 73% and an unchanged insufficient compression in 27%. Conclusion: In cases of insufficient compression, possible impediments should be identified and eliminated. Patients who do not perform any compression therapy, should be motivated with easy-to-handle compression therapy options like compression stocking systems.