Restricted accessReview articleFirst published online 2016-3
The comparative impact of conservative treatment versus superficial venous surgery,for the treatment of venous leg ulcers: A systematic review of the impact on patients’ quality of life
Leg ulcers are known to have a profound effect on patients’ quality of life; however, the influence of different treatment approaches is unclear. This review aims to evaluate the comparative impact of conservative treatments and superficial venous surgery, for venous leg ulcers, on patients’ Quality of Life.
Data sources
Three electronic databases (PsycInfo, Medline and CINAHL), and reference lists of relevant articles, were searched. A total of 209 articles were initially identified, and 16 articles were included in the review.
Results
The results lend cautious support to the suggestion that all treatments have a positive effect on quality of life, regardless of type, whilst wound status also appears to be an important factor.
Conclusions
Some evidence suggests that surgical treatment methods may lead to greater improvements in patients’ quality of life than compression bandaging alone; however, future research may focus on the psychological mechanisms underlying such changes.
SimonDDixFMcCollumC. Management of venous leg ulcers. BMJ2004; 328: 1358–1362.
2.
Scottish Intercolleagiate Guidelines Network (SIGN). Management of chronic venous leg ulcers. (Clinical Guideline No. 120). 2010. ISBN 978 1 905813 66 7.
3.
BriggsMFlemmingK. Living with leg ulceration: a synthesis of qualitative research. J Adv Nurs2007; 59: 319–328.
4.
HerberORSchneppWRiegerMA. A systematic review on the impact of leg ulceration on patients’ quality of life. Health Qual Life Outcomes2007; 5: 44–44.
5.
HowardDPJHowardAKothariA. The role of superficial venous surgery in the management of venous ulcers: a systematic review. Eur J Vasc Endovasc Surg2008; 36: 458–465.
6.
GohelMSBarwellJRTaylorM. Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial. BMJ2007; 335: 83–83.
7.
ValleMFMaruthurNMWilsonLM. Comparative effectiveness of advanced wound dressings for patients with chronic venous leg ulcers: A systematic review. Wound Repair Regen2014; 22: 193–204.
8.
MalasMBQaziULazarusG. Comparative effectiveness of surgical interventions aimed at treating underlying venous pathology in patients with chronic venous ulcer. J Vasc Surg Venous Lymphat Disord2014; 2: 212–25.
9.
Clarke-MoloneyMO’BrienJFGracePA. Health-related quality of life during four-layer compression bandaging for venous ulcer disease: a randomised controlled trial. Ir J Med Sci2005; 174: 21–25.
10.
JullAWalkerNParagV. Randomized clinical trial of honey-impregnated dressings for venous leg ulcers. Br J Surg2008; 95: 175–182.
11.
ZamboniPCisnoCMarchettiF. Minimally invasive surgical management of primary venous ulcers vs. compression treatment: a randomized clinical trial. Eur J Vasc Endovasc Surg2003; 25: 313–318.
12.
CharlesH. Does leg ulcer treatment improve patients’ quality of life?J Wound Care2004; 13: 209–213.
13.
FranksPJMoodyMMoffattCJ. Quality of life in a trial of short stretch versus four-layer bandaging in the management of chronic venous ulceration. Phlebology2004; 19: 87–91.
14.
FranksPMoffattCEllisonD. Quality of life in venous ulceration: A randomized trial of two bandage systems. Phlebology1999; 14: 95–99.
15.
GuestMSmithJJTripuraneniG. Randomized clinical trial of varicose vein surgery with compression versus compression alone for the treatment of venous ulceration. Phlebology2003; 18: 130–136.
16.
LoftusS. A longitudinal, quality of life study comparing four layer bandaging and superficial venous surgery for the treatment of venous leg ulcers. J Tissue Viability2001; 11: 14–19.
17.
MichaelsJACampbellBKingB. Randomized controlled trial and cost-effectiveness analysis of silver-donating antimicrobial dressings for venous leg ulcers (VULCAN trial). Br J Surg2009; 96: 1147–1156.
18.
FranksPJMoffattCJ. Health related quality of life in patients with venous ulceration: use of the Nottingham health profile. Qual Life Res2001; 10: 693–700.
19.
FinlaysonKJCourtneyMDGibbMA. The effectiveness of a four-layer compression bandage system in comparison with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers: a randomised controlled trial. Int Wound J2014; 11: 21–27.
20.
WellerCDEvansSMStaplesMP. Randomized clinical trial of three-layer tubular bandaging system for venous leg ulcers. Wound Repair Regen2012; 20: 822–829.
21.
Harding KG, Vanscheidt W, Partsch H, et al. Adaptive compression therapy for venous leg ulcers: a clinically effective, patient-centred approach. Int Wound J 2014; Epub, DOI: 10.1111/iwj.12292.
22.
MoffattCJEdwardsLCollierM. A randomised controlled 8-week crossover clinical evaluation of the 3M Coban 2 Layer Compression System versus Profore to evaluate the product performance in patients with venous leg ulcers. Int Wound J2008; 161: 267–279.
23.
BrizzioEAmslerFLunB. Comparison of low-strength compression stockings with bandages for the treatment of recalcitrant venous ulcers. J Vasc Surg2010; 51: 410–416.
24.
HarrisonMBVandenkerkhofEGHopmanWM. The Canadian Bandaging Trial: Evidence-informed leg ulcer care and the effectiveness of two compression technologies. BMC Nurs2011; 10: 20–20.
25.
ZamboniPCiscnoCMarchettiF. Erratum to minimally invasive surgical management of primary venous ulcers vs compression treatment: a randomized clinical trial. Eur J Vasc Endovasc Surg2003; 26: 337–338.
26.
HopmanWMBuchananMVanDerKerkhofEG. Pain and health-related quality of life in people with chronic leg ulcers. Chronic Dis Can2013; 33: 167–174.
27.
CriddleL. Healing from surgery: A phenomenological study. Image J Nurs Scholarsh1993; 25: 208–213.
28.
ChaseSKMelloniMSavageA. A forever healing: the lived experience of venous ulcer disease. J Vasc Nurs1997; 15: 73–78.
Ryan R. Cochrane Consumers and Communication Review Group. ‘Cochrane Consumers and Communication Review Group: meta-analysis. http://cccrg.cochrane.org. June 2013 (accessed January 2014).
