Intermittent pneumatic compression for treating venous leg ulcers.

BACKGROUND: Intermittent pneumatic compression (IPC) is a mechanical method of delivering compression to swollen limbs. This technique has been used to treat venous leg ulcers and limb swelling due to lymphoedema. The effectiveness of IPC, and the appropriate duration and frequency of IPC therapy are unknown as are the differences between various types of IPC. This review analyses the evidence for the effectiveness of IPC as a treatment for venous leg ulcers.

OBJECTIVES: To determine whether IPC increases the healing of venous leg ulcers. To determine the effects of IPC on health related quality of life of venous leg ulcer patients.

SEARCH STRATEGY: The Cochrane Wound Group Trials Register was searched for RCTs of intermittent pneumatic compression in February 2001. Journals and relevant conference proceedings were searched by hand. Companies were also contacted for relevant unpublished data or ongoing studies.

SELECTION CRITERIA: Randomised controlled studies either comparing IPC with control (sham IPC or no IPC) or comparisons between IPC treatment regimens, in venous ulcer management were included.

DATA COLLECTION AND ANALYSIS: Data extraction and assessment of study quality were undertaken by two reviewers independently.

MAIN RESULTS: Four randomised controlled trials were identified. One small trial (45 people) found increased ulcer healing with IPC plus compression than with compression alone (relative risk for healing 11.4, 95% Confidence Interval 1.6 to 82). Two small trials with a total of 75 people found no evidence of a benefit for IPC plus compression compared with compression alone. One small trial (16 people) found no difference between IPC (without additional compression) and compression bandages alone.

REVIEWER'S CONCLUSIONS: Further trials are required to determine whether IPC increases the healing of venous leg ulcers.