Randomised controlled trial comparing European standard class 1 to class 2 compression stockings for ulcer recurrence and patient compliance

Int Wound J. 2014 Aug;11(4):404-8. doi: 10.1111/j.1742-481X.2012.01108.x. Epub 2012 Oct 19.


The aim of this study was to determine the rate of venous ulcer recurrence and the level of compliance in patients wearing European class 1 or class 2 compression stockings. A total of 100 patients with healed venous leg ulcers were recruited, and were randomised to either class 1 (n = 50) or class 2 (n = 50) compression stockings. Follow-up was at 1 week, 3, 6, 9 and 12 months to monitor ulcer recurrence and compliance. Patients had a duplex scan to identify the source of venous incompetence. The rate of ulcer recurrence after 12 months was 16·1%, and the difference in recurrence rate between classes was not statistically significant (P = 0·287) although greater numbers in class 1 developed a recurrence. Participants (88·9%) were compliant; non-compliant patients were at a significantly greater risk of recurrence (P≤ 0·0001). Thirteen patients had both superficial and deep incompetence; those randomised to class 1 stockings (n = 4) developed ulcer recurrence. Patients with a history of multiple episodes of ulceration were more likely to develop a recurrence (P = 0·001). The lowest venous ulcer recurrence rates were seen in patients who were compliant with hosiery regardless of the compression level. Patients with both superficial and deep incompetence had a lower rate of recurrence with class 2 compression.

Keywords: Compliance; Compression hosiery; Recurrence; Venous leg ulcers.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Leg Ulcer / therapy*
  • Male
  • Middle Aged
  • Patient Compliance*
  • Pilot Projects
  • Recurrence
  • Stockings, Compression*
  • Time Factors
  • Treatment Outcome
  • Wound Healing*