Abstract
Introduction
The adequate use of compression in venous leg ulcer treatment is equally important to patients as well as clinicians. Currently there is a lack of clarity on contra-indications, risk factors, adverse events and complications, when applying compression therapy for venous leg ulcer patients.
Methods
The project aimed to optimize prevention, treatment and maintenance approaches by recognizing contra-indications, risk factors, adverse events and complications, when applying compression therapy for venous leg ulcer patients. A literature review was conducted of current guidelines on venous leg ulcer prevention, management and maintenance.
Results
Searches took place February 29 to April 30, 2016, were prospectively limited to publications in the English and German languages and publication dates were between January 2009 and April 2016. Twenty Guidelines, clinical pathways and consensus papers on compression therapy for venous leg ulcer treatment and for venous disease, were included. Guidelines agreed on the following absolute contraindications: Arterial occlusive disease, heart failure and ankle brachial pressure index (ABPI) < 0.5, but gave conflicting recommendations on relative contraindications, risks and adverse events. Moreover definitions were unclear and not consistent.
Conclusions
Evidence based guidance is needed to inform clinicians on risk factor, adverse effects, complications and contraindications. ABPI values need to be specified and details should be given on the type of compression that is safe to use. Ongoing research challenges the present recommendations, shifting some contraindications into a list of potential indications. Complications of compression can be prevented when adequate assessment is performed and clinicians are skilled in applying compression.
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