Andriessen A, Apelqvist J, Mosti G, Partsch H, Gonska C, Abel M, et al.
Journal of the European Academy of Dermatology and Venereology : JEADV. Date of publication 2017 Sep 1;volume 31(9):1562-1568.
1. J Eur Acad Dermatol Venereol. 2017 Sep;31(9):1562-1568. doi: 10.1111/jdv.14390.
Epub 2017 Jul 31.
Compression therapy for venous leg ulcers: risk factors for adverse events and
complications, contraindications - a review of present guidelines.
Andriessen A(1)(2), Apelqvist J(3), Mosti G(2)(4), Partsch H(2)(5), Gonska C(6),
Abel M(2)(6)(7).
Author information:
(1)Radboud UMC, Nijmegen & Andriessen Consultants, Malden, The Netherlands.
(2)International Compression Club (ICC), Berndorf, Austria.
(3)Department of Endocrinology, University Hospital of Malmö, Malmö, Sweden.
(4)Department of Angiology, Clinica MD Barbantini, Lucca, Italy.
(5)Medical University Vienna, Vienna, Austria.
(6)Medical & Regulatory Affairs, Lohmann & Rauscher GmbH & Co KG, Rengsdorf,
Germany.
(7)Patient Outcome Group (POG), European Wound Management Association (EWMA),
Frederiksberg, Denmark.
INTRODUCTION: The adequate use of compression in venous leg ulcer treatment is
equally important to patients as well as clinicians. Currently, there is a lack
of clarity on contraindications, risk factors, adverse events and complications,
when applying compression therapy for venous leg ulcer patients.
METHODS: The project aimed to optimize prevention, treatment and maintenance
approaches by recognizing contraindications, risk factors, adverse events and
complications, when applying compression therapy for venous leg ulcer patients. A
literature review was conducted of current guidelines on venous leg ulcer
prevention, management and maintenance.
RESULTS: Searches took place from 29th February 2016 to 30th April 2016 and were
prospectively limited to publications in the English and German languages and
publication dates were between January 2009 and April 2016. Twenty Guidelines,
clinical pathways and consensus papers on compression therapy for venous leg
ulcer treatment and for venous disease, were included. Guidelines agreed on the
following absolute contraindications: Arterial occlusive disease, heart failure
and ankle brachial pressure index (ABPI) <0.5, but gave conflicting
recommendations on relative contraindications, risks and adverse events. Moreover
definitions were unclear and not consistent.
CONCLUSIONS: Evidence-based guidance is needed to inform clinicians on risk
factor, adverse effects, complications and contraindications. ABPI values need to
be specified and details should be given on the type of compression that is safe
to use. Ongoing research challenges the present recommendations, shifting some
contraindications into a list of potential indications. Complications of
compression can be prevented when adequate assessment is performed and clinicians
are skilled in applying compression.
© 2017 European Academy of Dermatology and Venereology.
DOI: 10.1111/jdv.14390
PMID: 28602045 [Indexed for MEDLINE]
