Neurovascular changes after four-layer compression bandaging in people with chronic venous leg ulcers.

Abstract

Venous leg ulcers represent a major clinical problem, with poor rates of healing. Ideal treatment is compression bandaging. The effect of compression on neurovascular tissues involved in wound repair is unclear. This study aims to assess the effect of four-layer compression therapy (40 mmHg) on neurovascular function and wound healing in people with chronic venous leg ulcers--15 people (55 years or older) with venous leg ulcers for more than six weeks.Basal microvascular perfusion measurement (MPM), oxygen tension (tcpO2) measured at sensor temperatures of 39 degrees C and 44 degrees C and sensory nerve function using electrical cutaneous perception thresholds (ECPT) at 5, 250 and 2000 Hz (corresponding to C, Adelta and Abeta fibres) were assessed adjacent to the ulcer site, and at a mirror location on the non-ulcerated limb. Testing was undertaken before and after therapy for 5-12 weeks of four-layer compression bandaging.There was significant improvement in tcpO2 at 44 degrees C and ECPT at 2000 Hz (P < 0.05) compared with pre-intervention. Changes in basal MPM, tcpO2 at 39 degrees C and ECPT at 5 and 250 Hz after compression therapy did not reach statistical significance.Four-layer compression bandaging in people with venous leg ulcers improved some components of neurovascularture in people with chronic venous leg ulcers. Whether this improvement has contributed to wound healing in this study requires further investigation.