Risk Factors for Leg Ulcer Recurrence: A Randomized Trial of Two Types of Compression Stocking

Abstract

Patients with recently healed leg ulceration were entered into a study of leg ulcer recurrence. In all, 188 patients [69% women, mean age = 72 (SD = 12) years] were entered into the study, of whom 166 were considered suitable for ready-made stockings and were randomized to one of two class II below-knee compression stockings and followed for at least 18 months. The remaining patients required either made-to-measure stockings (5) or could not tolerate stockings owing to friable skin and were treated by other methods (17).

Overall cumulative recurrence rate was 26% after 1 year and 31% at 18 months. Independent risk factors for recurrence were previous ulcer size >10 cm ² (RR = 2.13, p = 0.009), history of deep vein thrombosis (RR = 2.34, p = 0.021) and unsuitability for stockings (RR = 2.52, p = 0.013). The randomized groups had similar cumulative 18-month recurrence rate (24% vs. 32%, p = 0.353). Of the 166 patients randomized to stockings, 25 (15%) could not put their stockings on at all and 43 (26%) were only able to put them on with great difficulty. The two stocking types differed significantly in this regard when analysed for trend.