References

Rabe E, Guex JJ, Puskas A Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 2012; 31:(2)105-115

Vuylsteke ME, Colman R, Thomis S An epidemiological survey of venous disease among general practitioner attendees in different geographical regions on the globe: the final results of the Vein Consult Program. Angiology. 2018; 69:(9)779-785 https://doi.org/10.1177/0003319718759834

Wrona M, Jöckel KH, Pannier F Association of venous disorders with leg symptoms: results from the Bonn Vein Study 1. Eur J Vasc Endovasc Surg. 2015; 50:(3)360-367 https://doi.org/10.1016/j.ejvs.2015.05.013

Robertson L, Lee AJ, Evans CJ Incidence of chronic venous disease in the Edinburgh Vein Study. J Vasc Surg Venous Lymphat Disord. 2013; 1:(1)59-67 https://doi.org/10.1016/j.jvsv.2012.05.006

Lee AJ, Robertson LA, Boghossian SM Progression of varicose veins and chronic venous insufficiency in the general population in the Edinburgh Vein Study. J Vasc Surg Venous Lymphat Disord. 2015; 3:(1)18-26 https://doi.org/10.1016/j.jvsv.2014.09.008

Wittens C, Davies AH, Bækgaard N Editor's choice – management of chronic venous disease. Eur J Vasc Endovasc Surg. 2015; 49:(6)678-737 https://doi.org/10.1016/j.ejvs.2015.02.007

Aloi TL, Camporese G, Izzo M Refining diagnosis and management of chronic venous disease: outcomes of a modified Delphi consensus process. Eur J Intern Med. 2019; 65:78-85 https://doi.org/10.1016/j.ejim.2019.03.005

Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014; 130:(4)333-346 https://doi.org/10.1161/CIRCULATIONAHA.113.006898

Lindholm C. Venous leg ulcer. Management, care, quality of life. Nord Med. 1996; 111:(5)139-141

Andreozzi GM, Cordova RM, Scomparin A Quality of life in chronic venous insufficiency. An Italian pilot study of the Triveneto Region. Int Angiol. 2005; 24:(3)272-277

Kurz X, Lamping DL, Kahn SR Do varicose veins affect quality of life? Results of an international populationbased study. J Vasc Surg. 2001; 34:(4)641-648 https://doi.org/10.1067/mva.2001.117333

Kaplan RM, Criqui MH, Denenberg JO Quality of life in patients with chronic venous disease: San Diego population study. J Vasc Surg. 2003; 37:(5)1047-1053 https://doi.org/10.1067/mva.2003.168

Herber OR, Schnepp W, Rieger MA. A systematic review on the impact of leg ulceration on patients' quality of life. Health Qual Life Outcomes. 2007; 5:(1) https://doi.org/10.1186/1477-75255-44

Meaume S, Dompmartin A, Lok C Quality of life in patients with leg ulcers: results from CHALLENGE, a double-blind randomised controlled trial. J Wound Care. 2017; 26:(7)368-379 https://doi.org/10.12968/jowc.2017.26.7.368

Augustin M, Brocatti LK, Rustenbach SJ Cost-of-illness of leg ulcers in the community. Int Wound J. 2014; 11:(3)283-292 https://doi.org/10.1111/j.1742481X.2012.01089.x

Margolis DJ, Allen-Taylor L, Hoffstad O, Berlin JA. The accuracy of venous leg ulcer prognostic models in a wound care system. Wound Repair Regen. 2004; 12:(2)163-168 https://doi.org/10.1111/j.1067-1927.2004.012207.x

Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK's National Health Service in 2017/2018: update from 2012/2013. BMJ Open. 2020; 10:(12) https://doi.org/10.1136/bmjopen-2020-045253

Franks PJ, Barker J, Collier M Management of patients with venous leg ulcer: challenges and current best practice. J Wound Care. 2016; 25:S1-S67 https://doi.org/10.12968/jowc.2016.25.Sup6.S1

Compression stockings for the prevention of venous leg ulcer recurrence: a health technology assessment. Ont Health Technol Assess Ser. 2019; 19:(2)1-86

Rabe E, Pannier F. Societal costs of chronic venous disease in CEAP C4, C5, C6 disease. Phlebology. 25:64-67 https://doi.org/10.1258/phleb.2010.010s09

Phillips CJ, Humphreys I, Thayer D Cost of managing patients with venous leg ulcers. Int Wound J. 2020; 17:(4)1074-1082 https://doi.org/10.1111/iwj.13366

Medical compression in chronic and limited venous conditions. Ann Dermatol Venereol. 2013; 140:(5)393-396 https://doi.org/10.1016/j.annder.2013.03.004

O'Donnell TF, Passman MA, Marston WA Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2014; 60:3S-59S https://doi.org/10.1016/j.jvs.2014.04.049

HAS. Managing venous leg ulcers (excluding dressings. Recommendations. 2006. https://tinyurl.com/3up52dy4 (accessed 3 May 2021)

Scottish Intercollegiate Guidelines Network. Management of chronic venous leg ulcers: a national clinical guideline. 2010. https://tinyurl.com/knxvkcxt (accessed 11 March 2021)

Simplifying venous leg ulcer management. Consensus recommendations. 2015. https://www.woundsinternational.com (accessed 11 March 2021)

O'Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2012; 11

Santler B, Goerge T. Chronic venous insufficiency – a review of pathophysiology, diagnosis, and treatment. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2017; 15:(5)538-556 https://doi.org/10.1111/ddg.13242

Lazareth I, Moffatt C, Dissemond J Efficacy of two compression systems in the management of VLUs: results of a European RCT. J Wound Care. 2012; 21:(11)553-565 https://doi.org/10.12968/jowc.2012.21.11.553

Ashby RL, Gabe R, Ali S Clinical and costeffectiveness of compression hosiery versus compression bandages in treatment of venous leg ulcers (Venous leg Ulcer Study IV, VenUS IV): a randomised controlled trial. Lancet. 2014; 383:(9920)871-879 https://doi.org/10.1016/S0140-6736(13)62368-5

Jünger M, Ladwig A, Bohbot S, Haase H. Comparison of interface pressures of three compression bandaging systems used on healthy. J Wound Care. 2009; 18:(11)474-480 https://doi.org/10.12968/jowc.2009.18.11.45000

Hanna R, Bohbot S, Connolly N. A comparison of inferface pressures of three compression bandage systems. Br J Nurs. 2008; 17:S16-S24 https://doi.org/10.12968/bjon.2008.17.Sup9.31661

Benigni JP, Lazareth I, Parpex P Efficacy, safety and acceptability of a new two-layer bandage system for venous leg ulcers. J Wound Care. 2007; 16:(9)385-390 https://doi.org/10.12968/jowc.2007.16.9.27866

Pilati L, Houserman D. Comparing 2-layer with traditional 4-layer compression therapy. Wound Manag Prev. 2020; 66:(4)8-9

Greenstein E, Tickner A. Addressing compression continuity, consistency, and comfort using a dual compression system. Wound Manag Prev. 2020; 66:(6)4-7

Lantis JC, Barrett C, Couch KS A dual compression system: preliminary clinical insights from the US. J Wound Care. 2020; 29:S29-S37 https://doi.org/10.12968/jowc.2020.29.Sup9.S29

Conde-Montero E, Bohbot S, Grado Sanz R Association of autologous punch grafting, TLC-NOSF dressing and multitype compression therapy to rapidly achieve wound closure in hard-to-heal venous leg ulcers. Journal de Médecine Vasculaire. 2020; 45:(6)316-325 https://doi.org/10.1016/j.jdmv.2020.10.123

Federal Institute for Drugs and Medical Devices. Recommendations of the Federal Institute for Drugs and Medical Devices and the Paul Ehrlich Institute on the planning, implementation and evaluation of application observations (AWB) of 7 July 2010. https://tinyurl.com/nb847ezh (accessed 3 May 2021)

Escaleira R, Cardoso M, Rego J Efficacy of a two-component compression system for the therapy of venous leg ulcers. J Wound Care. 2010; 19:(3)104-109 https://doi.org/10.12968/jowc.2010.19.3.47279

Bundesdatenschutzgesetz. Federal Data Protection Act. 2009. https://tinyurl.com/h87bkwaa (accessed 12 April 2021)

Weindorf M, Stoffels I, Klode J, Dissemond J. Effect of optic marks on compression bandages on the pressure of compression bandages: first results of a prospective clinical study in different collectives of users. Phlebologie. 2012; 41:(01)18-24 https://doi.org/10.1055/s-0037-1621797

Sermsathanasawadi N, Tarapongpun T, Pianchareonsin R Customizing elastic pressure bandages for reuse to a predetermined, sub-bandage pressure: a randomized controlled trial. Phlebology. 2018; 33:(9)627-635 https://doi.org/10.1177/0268355517746434

Skeik N, Manunga J, Mirza A. Caring for patients with venous insufficiency during the COVID-19 pandemic at a tertiary care center. J Vasc Surg Venous Lymphat Disord. 2020; 8:(4) https://doi.org/10.1016/j.jvsv.2020.04.023

Fletcher J, Atkin L, Murphy N Learning from COVID-19: Developing a more efficient tissue viability service. Wounds UK. 2020; 16:(3)77-81

Gohel MS, Heatley F, Liu X Early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration: the EVRA RCT. Health Technol Assess. 2019; 23:(24)1-96 https://doi.org/10.3310/hta23240

Protz K, Heyer K, Dissemond J Compression therapy – current practice of care: level of knowledge in patients with venous leg ulcers. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2016; 14:(12)1273-1282 https://doi.org/10.1111/ddg.12938

Renner R, Gebhardt C, Simon JC. Compliance to compression therapy in patients with existing venous leg ulcers. Results of a crosssectional study. Med Klin (Munich). 2010; 105:(1)1-6 https://doi.org/10.1007/s00063010-1001-2

Non-observance of medical compression in venous ulcers treatment. 2017. https://tinyurl.com/4d334wee (accessed 12 April 2021)

Venous leg ulcers treated in the community with a multicomponent compression system. 2020. https://tinyurl.com/84wzt79c (accessed 12 April 2021)

Weller CD, Buchbinder R, Johnston RV. Interventions for helping people adhere to compression treatments for venous leg ulceration. Cochrane Database Syst Rev. 2016; 3:(3) https://doi.org/10.1002/14651858.CD008378.pub3

Mosti G, Iabichella ML, Partsch H. Compression therapy in mixed ulcers increases venous output and arterial perfusion. J Vasc Surg. 2012; 55:(1)122-128 https://doi.org/10.1016/j.jvs.2011.07.071

Mosti G, Cavezzi A, Massimetti G, Partsch H. Recalcitrant venous leg ulcers may heal by outpatient treatment of venous disease even in the presence of concomitant arterial occlusive disease. Eur J Vasc Endovasc Surg. 2016; 52:(3)385-391 https://doi.org/10.1016/j.ejvs.2016.06.004

Mosti G, Cavezzi A, Bastiani L, Partsch H. Compression therapy is not contraindicated in diabetic patients with venous or mixed leg ulcer. J Clin Med. 2020; 9:(11) https://doi.org/10.3390/jcm9113709

Eder S, Dissemond J, Vanscheidt W Buergers test/pole test: simple clinical tests to screen the arterial perfusion before compression therapy. Phlebologie. 2020; 49:(02)108-110 https://doi.org/10.1055/a-0865-7947

What are contraindications of compression therapy in wound treatment today?. 2020. https://tinyurl.com/yfzr38nc (accessed 12 April 2021)

Eder S, Stücker M, Läuchli S, Dissemond J. Is compression therapy contraindicated for lower leg erysipelas?. Hautarzt. 2021; 72:(1)34-41 https://doi.org/10.1007/s00105-02004682-4

Multicomponent compression system use in patients with chronic venous insufficiency: a real-life prospective study

02 May 2021
25 min read
Volume 5 · Issue 2

Abstract

Objective:

Compression therapy is the cornerstone of therapeutic management of patients with chronic venous insufficiency (CVI). This study aimed to evaluate the efficacy and safety of a multicomponent compression system in an unselected population of patients with CVI problems under real-life conditions.

Method:

A prospective, multicentre, observational study with a multicomponent two-bandage compression system (UrgoK2, Laboratoires Urgo, France) was conducted in 103 centres in Germany. Main outcomes included wound healing rate, wound healing progression, assessment of oedema and ankle mobility, local tolerability and acceptance of the compression therapy.

Results:

A total of 702 patients with venous leg ulcers (VLU) and/or with lower limb oedema due to CVI were treated with the evaluated system for a mean (±standard deviation) duration of 27±17 days. By the last visit, 30.9% of wounds had healed and 61.8% had improved. Limb oedema was resolved in 66.7% of patients and an improvement of ankle mobility was reported in 44.2% of patients. The skin condition under the compression therapy was also considered as improved in 73.9% of patients and a substantial reduction of pain was achieved, both in number of patients reporting pain and in pain intensity. Compression therapy with the evaluated system was ‘very well’ or ‘well’ tolerated and ‘very well’ or ‘well’ accepted by >95% of patients. These positive outcomes were in line with the general opinion of physicians on the evaluated compression bandages, which were judged ‘very useful’ or ‘useful’ for >96.6% of patients. Similar results were reported regardless of the treated condition, VLU and/or limb oedema.

Conclusion:

Real-life data documented in this large observational study of non-selected patients receiving compression therapy in daily practice confirm the benefits and safety profile of the evaluated compression system. This study also confirms the high-level of performance and acceptability of the system, regardless of the characteristics of the wounds or patients at initiation of the treatment. The data support the use of this multicomponent compression system as one first-line intervention in patients with symptoms caused by CVI.

Chronic venous insufficiency (CVI) of the lower limbs is a common condition affecting 5–30% of the adult population worldwide, with a prevalence that is consistently increasing with age.1,2,3,4,5 Caused by functional abnormality of the venous system, CVI encompasses the more advanced and severe stages of chronic venous disease (CVD), from oedema and skin changes to active leg ulcers (stages C3 to C6 of the CEAP (clinical, etiological, anatomical and pathophysiological) classification, respectively).6,7

Various symptoms, such as feelings of tightness, itching, muscle cramps, swollen legs or pain when standing or walking, manifest themselves along with CVD; then as the disease progresses, with CVI, with increasing intensity over time.3 However, because these symptoms can be initially overlooked by patients and healthcare providers, it is suspected that CVI may be diagnosed too late in a number of cases.8,9 Improperly treated, this chronic and disabling disease progresses and gradually impairs the health-related quality of life (QoL) of patients, who may experience substantial pain, reduced mobility, increased anxiety, depression and social isolation.10,11,12,13,14,15

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