The treatment of venous leg ulcers often involves the use of compression therapy, which can be

administered through hosiery garments or compression bandages123. Both methods have been
found to be effective in healing venous leg ulcers.

In terms of healing times, studies have shown that they are similar for both treatments. For
instance, one study reported a median time to ulcer healing of 99 days in the hosiery group and
98 days in the bandage group. The proportion of ulcers healing was also found to be much the
same in the two groups.

However, there were differences noted in the recurrence of ulcers. Patients wearing hosiery
experienced fewer ulcer recurrences. This suggests that while both treatments are effective in
healing ulcers, hosiery might provide an added benefit in preventing recurrence.

In terms of patient comfort and adherence to treatment, several factors have been identified. One
study found that more hosiery participants changed their allocated treatment (38.3% hosiery vs
27.0% bandage; p=0.02)49. This suggests that while hosiery might be a viable alternative to
bandages, it might not be suitable for all patients109.

Factors influencing patients’ adherence to venous leg ulcer treatment include understanding the
management plan and rationale behind treatment, compression-related body image issues,
understanding consequences of not wearing compression, feeling overwhelmed because it’s not
getting better, hot weather and discomfort when wearing compression, cost of compression,
ability to wear compression, patience and persistence, and remembering self-care instructions11.

In terms of cost-effectiveness, one study found that the average mean costs were approximately
US$1.62 lower per participant per year in the hosiery group than in the bandage group812. This
suggests that hosiery might be a more cost-effective option for the treatment of venous leg
ulcers.
In conclusion, both compression hosiery and compression bandages are effective in treating
venous leg ulcers, with similar healing times. However, hosiery may offer an advantage in terms
of preventing ulcer recurrence, although it may not be suitable for all patients. Factors such as
patient comfort, adherence to treatment, and cost-effectiveness should also be considered when
choosing a treatment method. Further research is needed to explore these aspects in more detail.

Healing time

In terms of healing times, studies have shown that they are similar for both treatments. For
instance, one study reported a median time to ulcer healing of 99 days in the hosiery group and
98 days in the bandage group1. The proportion of ulcers healing was also found to be much the
same in the two groups (70.9% hosiery and 70.4% bandage)1.

Further research suggests that a monthly surface area reduction of 30% provides a baseline
healing rate for venous leg ulcers managed with compression therapy and advanced dressings1.
This indicates that both compression hosiery and bandages can effectively reduce the size of the
ulcer over time, leading to eventual healing. Moreover, with appropriate treatment, venous leg
ulcers often heal within 6 months2. This healing time applies to both compression hosiery and
bandages, further emphasizing their similar effectiveness. However, it’s important to note that
treatment should always be carried out by a healthcare professional trained in compression
therapy for leg ulcers2. This ensures the correct application and use of the compression method,
whether it be hosiery or bandages, to maximize healing potential.

Comfort

In terms of patient comfort and adherence to treatment, several factors have been identified. One
study found that more hosiery participants changed their allocated treatment (38.3% hosiery vs
27.0% bandage; p=0.02). This suggests that while hosiery might be a viable alternative to
bandages, it might not be suitable for all patients.
Further research has identified five determinant themes regarding patients’ reasons for non-
compliance with compression therapy: pain and discomfort, psychosocial issues, knowledge
deficit, physical limitations, and financial issues1. These factors can significantly influence a
patient’s adherence to treatment and ultimately, the effectiveness of the treatment. Pain and
discomfort are common reasons for non-compliance. Compression therapy can sometimes cause
discomfort, especially if the compression is too tight or if the patient has other underlying
conditions that make wearing compression garments uncomfortable1. Psychosocial issues also
play a significant role. The appearance of compression garments can affect a patient’s body
image and self-esteem, which can lead to non-compliance1. Additionally, the need to wear these
garments daily can interfere with the patient’s lifestyle and social activities1.

A knowledge deficit about the importance of compression therapy and how to properly use the
garments can also lead to non-compliance1. Patients who do not understand the purpose of the
treatment or how to correctly use the garments are less likely to adhere to the treatment1.
Physical limitations, such as difficulty in putting on or taking off the garments, can also affect
compliance1. Elderly patients or those with physical disabilities may find it challenging to use
compression garments without assistance1. Lastly, financial issues can be a barrier to
compliance. Compression garments can be expensive, and not all patients can afford them1. In
some cases, insurance may not cover the cost of these garments, further exacerbating the
financial burden1.

In conclusion, while compression hosiery may be a viable alternative to bandages, it might not
be suitable for all patients due to various factors influencing patient comfort and adherence to
treatment. Therefore, healthcare professionals should consider these factors when recommending
a treatment method for venous leg ulcers.

https://www.acc.org/latest-in-cardiology/journal-scans/2014/03/17/17/11/clinical-and-cost-
effectiveness-of-compression-hosiery

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2813%2962368-5.pdf
https://core.ac.uk/download/pdf/82289682.pdf

https://research.manchester.ac.uk/en/publications/clinical-and-cost-effectiveness-of-
compression-hosiery-versus-com

https://research.manchester.ac.uk/en/publications/clinical-and-cost-effectiveness-of-
compression-hosiery-versus-com

https://journals.cambridgemedia.com.au/wpr/volume-27-number-4/patient-perspectives-
explaining-low-rates-compliance-compression-therapy

https://www.journalslibrary.nihr.ac.uk/hta/hta18570/#/abstract

https://www.acutetrainingsolutions.co.uk/wp-content/uploads/2021/09/
WoundMan_CompressionBandage_ATSL_LA.pdf

https://www.cochrane.org/CD008378/WOUNDS_interventions-helping-people-adhere-
compression-treatments-aid-healing-venous-leg-ulcers

https://journals.cambridgemedia.com.au/wpr/volume-27-number-4/patient-perspectives-
explaining-low-rates-compliance-compression-therapy