Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: A randomised controlled trial

2014 ◽  
Vol 30 (10) ◽  
pp. 693-699 ◽  
Author(s):  
CE Davies ◽  
G Woolfrey ◽  
N Hogg ◽  
J Dyer ◽  
A Cooper ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Leg Ulcers ◽  
Median Percentage ◽  
Ulcer Size ◽  
Wound Debridement ◽  
Venous Leg Ulcers ◽  
Area Reduction ◽  
Compression Bandaging ◽  
Compression Bandages ◽  
Chronic Leg Ulcers

Objectives Slough in chronic venous leg ulcers may be associated with delayed healing. The purpose of this study was to assess larval debridement in chronic venous leg ulcers and to assess subsequent effect on healing. Methods All patients with chronic leg ulcers presenting to the leg ulcer service were evaluated for the study. Exclusion criteria were: ankle brachial pressure indices <0.85 or >1.25, no venous reflux on duplex and <20% of ulcer surface covered with slough. Participants were randomly allocated to either 4-layer compression bandaging alone or 4-layer compression bandaging + larvae. Surface areas of ulcer and slough were assessed on day 4; 4-layer compression bandaging was then continued and ulcer size was measured every 2 weeks for up to 12 weeks. Results A total of 601 patients with chronic leg ulcers were screened between November 2008 and July 2012. Of these, 20 were randomised to 4-layer compression bandaging and 20 to 4-layer compression bandaging + larvae. Median (range) ulcer size was 10.8 (3–21.3) cm2 and 8.1 (4.3–13.5) cm2 in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Mann–Whitney U test, P = 0.184). On day 4, median reduction in slough area was 3.7 cm2 in the 4-layer compression bandaging group ( P < 0.05) and 4.2 cm2 ( P < 0.001) in the 4-layer compression bandaging + larvae group. Median percentage area reduction of slough was 50% in the 4-layer compression bandaging group and 84% in the 4-layer compression bandaging + larvae group (Mann–Whitney U test, P < 0.05). The 12-week healing rate was 73% and 68% in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Kaplan–Meier analysis, P = 0.664). Conclusions Larval debridement therapy improves wound debridement in chronic venous leg ulcers treated with multilayer compression bandages. However, no subsequent improvement in ulcer healing was demonstrated.

Venous Leg Ulcer Healing: A Randomized Prospective Study of Long-Stretch versus Short-Stretch Compression Bandages

1998 ◽  
Vol 13 (2) ◽  
pp. 59-63 ◽  
Author(s):  
L. Danielsen ◽  
S. M. Madsen ◽  
L. Henriksen
Keyword(s):  
Ulcer Healing ◽  
Venous Ulcer ◽  
Positive Influence ◽  
Compression Bandage ◽  
Leg Ulcers ◽  
Venous Leg Ulcer ◽  
Venous Leg Ulcers ◽  
Area Reduction ◽  
Compression Bandages ◽  
Table Analysis

Objective: To compare the efficacy of a long-stretch bandage with that of a short-stretch compression bandage. Design: Prospective evaluation of healing of venous leg ulcers in blindly randomized groups of patients. Setting: Bispebjerg Hospital, Copenhagen, Denmark. Patients: Forty-three patients with venous leg ulcers were included. Forty legs in 40 patients were evaluated at 1 month (34 patients), 6 months (32 patients) or 12 months (27 patients). Interventions: Both types of bandage were used at a width of 10 cm and applied using the same spiral bandaging technique. Main outcome measures: Ulcer healing and ulcer area reduction. Results: Healed ulcers after 1 month were observed in 27% of the long-stretch group and in 5% of the short-stretch group ( p = 0.15); after 6 months the corresponding figures were 50% and 36% ( p = 0.49) and after 12 months 71% and 30% ( p = 0.06). Using life-table analysis the predicted healing rate in the long-stretch group after 12 months was 81% and for the short-stretch group 31% ( p = 0.03). The mean of relative ulcer areas at 1 month was 0.45 for the long-stretch group and 0.72 for the short-stretch group ( p = 0.07), at 6 months the corresponding figures were 0.81 and 0.60 ( p = 0.25) and at 12 months 0.25 and 0.95 ( p = 0.01). Conclusions: The present study appears to indicate a Positive influence of the elasticity of a compression bandage on venous ulcer healing.

Testing Compression Bandages

1988 ◽  
Vol 3 (1) ◽  
pp. 55-61 ◽  
Author(s):  
W.G. Tennant ◽  
K.G.M. Park ◽  
C.V. Ruckley
Keyword(s):  
Standard Technique ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Pressure Measurements ◽  
Venous Leg Ulcers ◽  
Compression Bandaging ◽  
Compression Bandages ◽  
Blue Line ◽  
The Uk

Compression bandaging is the mainstay of the treatment of chronic venous leg ulcers. Using the Borgnis Medical Stocking Tester, six bandages in common use; (Blue Line, J-Press, Medirip, Elastocrepe, Crepe, and Elastoplast), were studied for the pressures attained, and the ability to sustain pressure. Each bandage was applied 10 times by one of two observers using a standard technique. Pressure measurements were taken hourly for 4h. The pressure exerted by Crepe fell by 63%, and that exerted by Elastoplast fell by 40% over the 4-h test period. Medirip and Blue Line gave the best sustained support. Bandages available on the UK drug tariff are in the main unsatisfactory for the treatment of chronic venous disease.

Effect of different compression bandaging techniques on the healing rate of venous leg ulcers: a literature review

2020 ◽  
Vol 25 (Sup6) ◽  
pp. S20-S26
Author(s):  
Emily Fulcher ◽  
Neil Gopee
Keyword(s):  
Quality Of Life ◽  
Healing Rate ◽  
Cost Effective ◽  
Compression Therapy ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Compression Bandaging ◽  
Search Terms ◽  
Compression Bandages

Venous leg ulcers (VLUs) are a common health problem in older adults, for which the widely used method of treatment includes compression therapy. There are various compression bandages and hosiery systems available for use, but it remains unclear as to which types of compression systems are most effective in enabling healing of VLUs. This study aimed to determine which type of the two most commonly used compression bandaging (four-layer and two-layer) is more effective in providing complete ulcer healing of VLUs. Key search terms were identified using the PICO (population, intervention, comparison, outcome) model, with distinct inclusion and exclusion criteria, in a strategic search of electronic databases (e.g. CINAHL and MEDLINE) along with wider sources, including Google Scholar. More studies favoured the four-layer compression system than two-layer for providing better healing rates in the treatment of VLUs, but two-layer bandaging tends to provide a better quality of life and may be more cost-effective, although comorbidities and other factors also need to be considered. In choosing the type of compression bandage for the management of leg ulcers, the healing rate achieved by the chosen bandage needs to be carefully monitored, while also taking into consideration other factors such as the quality of life for the patient.

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