Graduated Compression Elastic Stockings Reduce Lipodermatosclerosis and Ulcer Recurrence

Abstract

Objective:

To assess the effect of elastic stockings on reducing the area of lipodermatosclerosis in patients with healed venous ulceration.

Design:

Patients in this study were part of a randomised controlled trial to assess elastic stockings in preventing venous ulcer recurrence.

Setting:

Leg ulcer clinic at a tertiary teaching hospital.

Patients:

Consecutive consenting patients with leg ulcers due to venous disease alone, that had healed 2 weeks previously.

Interventions:

Patients were randomised to below-knee graduated compression stockings (Venosan 2003) or no stockings.

Main outcome measures:

Patients had the area of lipodermatosclerosis measured on admission to the study and at 6-monthly intervals. Time to ulcer recurrence was also recorded for a 2-year follow-up period.

Results:

One hundred and fifty-three patients were randomised to the main study (stockings 72, no stockings 81); 52 had re-ulcerated by 6 months (15 stockings, 37 no stockings). Lipodermatosclerosis was significantly reduced after 6 and 12 months in those patients wearing stockings but not in the control group (repeat measures ANOVA p = 0.01, p = 0.04). The initial area of lipodermatosclerosis was significantly larger in those patients who re-ulcerated within 2 years of entering the study compared with those who did not re-ulcerate (re-ulceration, 293 cm²; no re-ulceration, 50 cm²).

Conclusions:

Elastic stockings alone can improve the skin changes of lipodermatosclerosis and lower the rate of ulcer recurrence.