Adjustable Compression Wraps Offer No Healing Advantage for Venous Leg Ulcers

Venous leg ulcers present a formidable challenge in modern clinical practice, often requiring months of specialized care while causing severe pain and reduced mobility for patients. These chronic wounds develop when dysfunctional valves in the calf veins lead to ambulatory venous hypertension, increasing capillary pressure and damaging surrounding tissue. To counteract this fluid buildup and support blood flow, healthcare providers rely heavily on external compression therapy as a cornerstone of management.

However, the specific device used to deliver that compression has sparked ongoing debate among clinicians. While traditional multi-layer bandages and compression stockings have decades of clinical backing, adjustable compression wraps secured with Velcro-style straps have surged in popularity. Because patients or their caregivers can easily self-apply and adjust these wraps, manufacturers market them as a convenient alternative. Until now, high-quality comparative data evaluating whether these devices actually speed up wound healing remained scarce.

The VENous Ulcer Study 6 Trial Design and Findings

The study enrolled 637 adults suffering from venous leg ulcers, assigning them to receive either compression wraps, two-layer compression bandages, or established evidence-based treatments such as four-layer bandages or two-layer compression stockings.

The trial’s primary findings challenged the assumption that newer convenience-focused devices outperform standard care. Ulcers healed more slowly in patients assigned to compression wraps than in those treated with established evidence-based compression options. Meanwhile, standard two-layer bandages performed comparably to traditional established treatments.

“Venous leg ulcers can have a major impact on people’s quality of life and place a significant burden on health care services, so it is important that health professionals have robust evidence to guide treatment decisions. Our study compared three commonly used strong compression approaches in a real-world NHS setting and suggested that compression wraps do not improve healing times when compared with established evidence-based treatments.”

Jo Dumville, professor of applied health research at the University of Manchester

Patient Comfort Versus Therapeutic Pressure

Consequently, researchers concluded that wraps should not automatically serve as the default first-choice therapy for every patient.

“While some uncertainty remains, these findings suggest that compression wraps are unlikely to offer a healing advantage as a first-line treatment. The results will help clinicians, patients and health care providers make informed decisions about the most appropriate therapies for managing venous leg ulcers.”

Catherine Arundel, senior research fellow at the University of York

Broader Context in Chronic Wound Management

The findings arrive against a backdrop of varied clinical approaches to chronic lower extremity ulcers. Landmark trials in the broader field have investigated different avenues for accelerating recovery.

At the same time, observational and audit data highlight persistent gaps in routine care delivery. Point prevalence surveys conducted across English healthcare districts have previously revealed that meaningful shares of patients with active venous leg ulceration—ranging from 25% up to 46% in specific regional audits—were not placed in compression therapy at all, often due to a lack of clinical confidence or knowledge among providers.