Challenging the Use of Bandage Compression as the Baseline for Evaluating the Healing Outcomes of Venous Leg Ulcer-Related Compression Therapies in the Community and Outpatient Setting: An Integrative Review

Background: Venous ulcers have considerable human and financial costs. Bandage compression is the most common type of compression used to enhance healing. Ulcer size, pretreatment ulcer duration, and the consistency of pressure (depending on the competency of the bandager) significantly affect the healing process. Summary: The aim of this review is to explore whether the variability in bandage-related baselines contributes to the differences in healing outcomes among the empirical studies designed to evaluate bandage compression for treating venous ulcers in community and outpatient settings. Two health-related databases were searched: Medline and the Cumulative Index for Nursing and Allied Health. A manual search of relevant reviews and publication reference lists was also undertaken. Fourteen studies were included. The most common study design was a randomized controlled trial. Only one study used a cohort design. This review focused on two variables: healing rate and healing time. The ulcer features, the consistency of the pressure level, and the competency of the bandager were the main factors within the reviewed studies that affect the baselines and healing outcomes. Key Messages: This integrative review confirms that the large variability in the baselines results from differences in the ulcer size, duration, competency level, and amount of pressure that led to differing healing outcomes. Future research designs need to pay attention to make the baselines consistent by ensuring that the ulcer size, duration, competency of the nurses, and level of compression are comparable and consistent within the studies' design.