Review: compression was effective for healing venous ulcers, and multicomponent systems were better than single-component ones.

ED FROM O’Meara S, Cullum NA, Nelson EA. Compression for venous leg ulcers. Cochrane Database Syst Rev 2009;(1):CD000265. Correspondence to: Dr S O’Meara, University of York, York, UK; [email protected] Source of funding: National Institute for Health Research, UK. c Clinical impact ratings: General/internal medicine 6/7; Haematology (except oncology) 5/7; Wound care 6/7 C O M M EN TA R Y T he timely review by O’Meara at al evaluates comprehensively the current evidence base for use of compression therapy in the management of venous ulceration. It supports the use of compression as the ‘‘gold standard’’ for uncomplicated venous leg ulcers and the finding that multicomponent systems containing elastic bandages are more effective than those composed mainly of inelastic constituents. Importantly, it shows improvement in recent years in the methodological quality of included RCTs, which adds strength to the conclusions of the review. Consequently, research for management of venous ulcers must now surely shift to implementation strategies. This should focus on education and training of professionals, and improvement of healthcare resources that can support implementation. With an estimated 490 000 to 1.3 million European Union citizens having leg ulceration (all types), there are examples of best practice that could guide implementation and further improve patient outcomes. 2 This review identifies the need for future research to incorporate cost-effectiveness and quality of life measures within protocols. In the current constrained economic environment, such requests should be supported as this may influence not only current service delivery but future resource allocation for management of venous leg ulcers. The authors have provided a valuable resource of current evidence that will be of value to clinicians, policy makers, governing bodies, and patients alike. Georgina Gethin, RGN, PhD, FFNMRCSI Royal College of Surgeons in Ireland Dublin, Ireland 1. Posnett J, Gottrup F, Lundgren H, et al. The resource impact of wounds on health-care providers in Europe. J Wound Care 2009;18:154–61. 2. Clarke-Moloney M, Keane N, Kavanagh E. Changes in leg ulcer management practice following training in an Irish community setting. J Wound Care 2008;17: 116, 118–21. Treatment 116 EBN October 2009 Vol 12 No 4 group.bmj.com on June 16, 2017 Published by http://ebn.bmj.com/ Downloaded from