Prospective Comparison of Healing Rates and Therapy Costs for Conventional and Four-Layer High-Compression Bandaging Treatments of Venous Leg Ulcers

Abstract

Objective: To compare healing rates and associated treatment costs of four-layer high-compression bandaging (HCB) and conventional management (CM), as available on FP10, in the treatment of venous leg ulcers. Design: Randomized prospective study in which patients were allocated to one of two treatment groups. Setting: Hospital-based leg ulcer service and community. Patients: Thirty-six patients presenting with venous leg ulcers (30 compilers): 16 patients (nine female) in the HCB group and 14 patients (10 female) in the CM group. Interventions: A 12-week treatment period with either a four-layer HCB regime or CM. Main outcome measures: The significance of the difference between the number of ulcers healed, and associated treatment costs, was investigated using the Mann–Whitney U-test and survival analysis. Results: Four-layer HCB achieves a significantly ( p = 0.003) higher healing rate of ulcers (75% of patients versus 21%) over a 12-week period. Weekly treatment costs for the four-layer therapy was significantly less than that of CM (mean difference in cost = £6.45, 95% CI = £1.22–11.68; p = 0.042). Conclusion: It is more efficacious and economical for nurse specialists to treat patients presenting with leg ulcers with a four-layer HCB regime than for district nurses to carry out the standard palliative treatments available on GP prescription form FP10.