Compression therapy for venous leg ulcers

Compression therapy is the mainstay of treatment of venous leg ulcers (VLU). Good wound care and compression therapy will heal majority of small venous ulcers of short duration.[] Goals of compression therapy are ulcer healing, reduction of pain and edema, and prevention of recurrence.[] Compression is used for VLU and narrows veins and restores valve competence and reduces ambulatory venous pressure, thus reducing venous reflux (VR). It also helps decrease inflammatory cytokines, accelerates capillary flow, and lowers capillary fluid leakage thereby alleviating limb edema. It also softens lipodermatosclerosis, improves lymphatic flow and function, and enhances fibrinolysis.



The aim of compression therapy is to improve the venous function without compromising arterial function.



The contraindications of compression therapy are the following[,]

  • Advanced peripheral obstructive arterial disease (ankle brachial pressure index [ABPI] <0.8) (Evidence level A)
  • Systemic arterial pressure <80 mm Hg at ankle
  • Phlegmasia cerulea dolens
  • Uncontrolled congestive heart failure
  • Abscesses
  • Septic phlebitis
  • Advanced peripheral neuropathy.

read more