Neurovascular changes after four-layer compression bandaging in people with chronic venous leg ulcers

Abstract

Objectives : Venous leg ulcers represent a major clinical problem, with poor rates of healing. Ideal treatment is compression bandaging. The effect of compression on neurovascular tissues involved in wound repair is unclear. This study aims to assess the effect of four-layer compression therapy (40 mmHg) on neurovascular function and wound healing in people with chronic venous leg ulcers – 15 people (55 years or older) with venous leg ulcers for more than six weeks.

Methods : Basal microvascular perfusion measurement (MPM), oxygen tension (tcpO₂) measured at sensor temperatures of 39°C and 44°C and sensory nerve function using electrical cutaneous perception thresholds (ECPT) at 5, 250 and 2000 Hz (corresponding to C, Aδ and Aβ fibres) were assessed adjacent to the ulcer site, and at a mirror location on the non-ulcerated limb. Testing was undertaken before and after therapy for 5–12 weeks of four-layer compression bandaging.

Results : There was significant improvement in tcpO₂ at 44°C and ECPT at 2000 Hz (P<0.05) compared with pre-intervention. Changes in basal MPM, tcpO₂ at 39°C and ECPT at 5 and 250 Hz after compression therapy did not reach statistical significance.

Conclusion : Four-layer compression bandaging in people with venous leg ulcers improved some components of neurovascularture in people with chronic venous leg ulcers. Whether this improvement has contributed to wound healing in this study requires further investigation.