CLINICAL QUESTION

Do compression stockings prevent the recurrence of lower extremity venous ulcers?

EVIDENCE-BASED ANSWER

Compression stockings can reduce the recurrence of venous leg ulcers, based on limited evidence. Higher-grade compression is more effective, but patients are more likely to be noncompliant with therapy.¹ (Strength of Recommendation: B, systematic review of few fair-quality trials.)

PRACTICE POINTERS

Venous ulcers are relatively common in primary care, with an incidence of 1% to 3% in all adults and 4% in patients older than 65 years.² Venous ulcers, also known as venous stasis ulcers, are the most common type of lower extremity ulcers. Compression stockings are a mainstay of venous stasis leg ulcer therapy; compression is also recommended after healing to prevent recurrence.^2,3

Different grades of compression stockings are available, and countries and regions have varying ways of categorizing these grades. This review uses mainly European Union and United Kingdom compression categories. For convenience, these categories have been converted to approximate commercial US equivalents for venous compression: light (ie, 15–20 mm Hg), medium (ie, 20–30 mm Hg), and heavy (ie, 30–40 mm Hg). The United Kingdom classes overlap the US versions, and this is noted in the results. The authors of this Cochrane systematic review examined the evidence for compression interventions, including bandages and hosiery, in preventing the recurrence of venous leg ulcers.¹