Surgical intervention as an adjunct to compression therapy in healing of venous leg ulcers

Abstract

Overview of the topic: Venous Leg Ulcers (VLUs) are open lesions located between the knee and the ankle joint occurring due to the presence of venous disease (DynaMed, n.d.). They are usually characterized by irregular borders and the weeping of serous fluid. In this dissertation, the comparison between compression only therapy versus combined therapy will be assessed to observe which is more effective in increasing healing of VLUs. The research question: Amongst patients suffering from venous leg ulcers, how does compression therapy alone versus a combination of both compression and surgical treatment affect the healing rate of venous leg ulcers? PICO elements: Population: patients suffering from VLUs. Intervention: compression only treatment. Comparison: combination of both compression and surgical treatment. Outcome: healing of VLUs. Method: The PICO was utilised to identify the key terms. These terms were merged with search tools and limiters which were used to search the available literature in databases and platforms such as EBSCO, ScienceDirect and HyDi. The PRISMA tool together with an inclusion and exclusion criteria were used to aid the selection of the key studies. The Critical Appraisal Skills Programme (CASP) tool was utilised to critically appraise all of the chosen studies. Results: The key studies consisted of six randomized controlled trials (RCTs) and one cohort study. A conclusive answer was not able to be extracted due to the inconsistency of the results, despite having two studies favouring the combined therapy intervention there were several limitations being the likely cause for this to occur. Conclusion: A concrete conclusion could not be identified due to key studies chosen having several limitations including multiple outcomes. Implications and recommendations: Recommendations to improve research include conducting further studies with larger sample sizes and more focused interventions. Implementation of the findings locally require more studies and resource allocation.