Which venous leg ulcers will heal with limb compression bandages?

Am J Med. 2000 Jul;109(1):15-9. doi: 10.1016/s0002-9343(00)00379-x.


Purpose: To develop a simple prediction rule to identify patients in whom a venous leg ulcer will heal using a limb compression bandage (eg, Unna's boot).

Subjects and methods: We performed a retrospective cohort study of patients with venous leg ulcers who received a limb compression bandage applied weekly. Prognostic factors were assessed from the patient's history before the start of treatment. The outcome of interest was a healed wound within 24 weeks of treatment. The final model was validated in another data set.

Results: Several accurate prognostic models were developed. The simplest model summed the size and duration of the wound before treatment, with 1 point given for a wound with an area >5 cm(2) and another if the wound was >6 months old. In the development data set, ulcers healed in 93% (110 of 118) of patients with a score of 0, but in only 13% (9 of 67) of those with a score of 2. In the validation data set, ulcers healed in 95% (19 of 20) of patients with a score of 0, and 37% (44 of 120) of those with a score of 2.

Conclusions: This simple prognostic model can be used to discriminate between patients with a venous leg ulcer that will or will not heal within 24 weeks of care with a limb compression bandage. The model may be useful in determining which patients to treat with a limb compression, and which patients should be referred or considered for alternative treatments.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Bandages*
  • Chronic Disease
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Varicose Ulcer / pathology
  • Varicose Ulcer / therapy*
  • Wound Healing*