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Stockings perform better than bandages to treat leg ulcers

06 Dec 2013

A new study has found that leg ulcers take the same time to heal when people wear compression stockings rather than traditional bandages.

People in a trial, carried out by researchers from the universities of Manchester and York and funded by the National Institute for Health Research as part of their Health Technology Assessment programme (NIHR HTA), also reported less ulcer recurrence after using the stockings and required fewer nurse visits making the stockings better value for money for the NHS.

But the study, published in The Lancet today (6 December), also found that not everyone liked to wear the stockings with more people changing from this to another treatment compared with those in the bandage group.

Venous leg ulcers are common chronic wounds that are painful, recur and reduce quality of life. They are a consequence of damage or blockage to the veins of the leg which can result in skin breakdown and impaired healing.

Bandages which apply pressure to the leg, called multi-layer compression bandages, have until now been the main treatment for venous leg ulcers and are used by thousands of people. But the current method of treating these wounds costs the NHS millions of pounds per year.

Dr Jo Dumville, Senior Lecturer in Applied Health Research at The University of Manchester’s School of Nursing, Midwifery and Social Work who was the chief investigator on the study, said: “The finding that compression stockings are a cost effective treatment for venous leg ulcers is important for patients, carers and the NHS.

“Compression bandages are bulky, unattractive and may interfere with normal footwear, they can also be costly as they take time to apply and often require frequent nurse visits to change them.”

The study, known as Venous leg Ulcer Study IV (VenUS IV), saw 454 people trial the two methods and will now help inform nursing practice.

Nikki Stubbs, Clinical Lead at Leeds Community Healthcare NHS Trust, said: “The findings support the use of compression stockings for some people with venous leg ulcers. Where appropriate, the day to day application of stockings can be undertaken by patients, carers and a range of health professionals. From a patient perspective this may promote independence as well as enabling the NHS to maximise the use of its resources to best effect.”
 
ENDS

Notes for editors

For further information or to request an interview or advanced copy of the paper, please contact Alison Barbuti in The University of Manchester Press Office on 0161 275 8383 or email alison.barbuti@manchester.ac.uk.

The research team has produced three previous large venous ulcer studies all funded by the NIHR HTA programme. They are part of the Editorial Base of the Cochrane Wounds Group which conducts and publishes high quality systematic reviews of the evidence for wound treatments.

The University of Manchester
The University of Manchester, a member of the Russell Group, is one of the largest and most popular universities in the UK. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is one of the country’s major research institutions, rated third in the UK in terms of ‘research power’. The University has an annual income of £807 million and is ranked 40th in the world and fifth in the UK for the quality of its teaching and impact of its research.

The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme funds research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 600 issues published to date. The journal’s 2011 Impact Factor (4.255) ranked it in the top 10% of medical and health-related journals. All issues are available for download, free of charge, from the website. The HTA Programme is funded by the NIHR, with contributions from the CSO in Scotland, NISCHR in Wales, and the HSC R&D Division, Public Health Agency in Northern Ireland.www.hta.ac.uk.

The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.