The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Randomized controlled trial of four‐layer bandaging and simple venous surgery for venous ulceration. BJS 2001; 88: 606-606.

Published: 6th December 2002

Authors: M. G. Guest, J. J. Smith, R. M. Greenhalgh, A. H. Davies

Background

No randomized controlled trials exist to show whether simple venous surgery benefits healing or maintenance of healing of venous ulcers.

Method

Some 121 consecutive patients with new episodes of venous ulceration were identified; 45 patients were unfit or unwilling for randomization. The remaining 76 (39 women) were assigned randomly to received a four‐layer bandage (n = 39) or simple venous surgery (n = 37). All patients were followed for a minimum of 6 months. Outcome was assessed at a minimum of 6 months as healing and health‐related quality of life (HRQL).

Results

The two groups had similar co‐morbidity and pattern of venous incompetence. There were no major complications in either group. The healing rate was 64 per cent (25 of 39) in the conservatively treated group and 68 per cent (25 of 37) in the operated group (P = 0·75, Pearson χ2 test). There was no significant difference between time to ulcer healing in the two treatment groups (log rank statistic = 0·69, P = 0·41). Patterns of venous incompetence did not affect the healing rate. There were no major differences in HRQL between the two groups.

Conclusion

This pilot study suggests that simple venous surgery gives no adjuvant benefit to four‐layer bandaging in venous ulceration from the point of view of healing rate and quality of life. © 2001 British Journal of Surgery Society Ltd

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