Venous ulcer healing by four-layer compression bandaging is not influenced by the pattern of venous incompetence

Background: Previous studies have related deep venous incompetence to reduced venous ulcer healing rates. The aim of this study was to determine the relationship between the pattern of venous incompetence and ulcer healing. Methods: A total of 198 legs with venous ulceration were investigated with colour venous duplex imaging to determine the presence and site of venous incompetence. All were treated initially with the four-layer bandage technique. Results: At 6 months, 74 per cent of the venous ulcers had healed using the four-layer bandage technique. There was no significant correlation between the pattern of incompetence and the healing rate of the ulcer. Previous deep vein thrombosis (DVT), increased size of the ulcer and previous episodes of ulceration were associated with a poor healing rate. Conclusion: The four-layer bandage technique achieved an ulcer healing rate of 74 per cent after 6 months, irrespective of the pattern of venous incompetence. Patients with a large ulcer, previous DVT or previous episodes of ulceration had delayed healing, supporting the previous literature.