Topical negative pressure therapy and compression in the management of venous leg ulcers: a pilot study

Objective: Venous leg ulceration (VLU) is a common condition associated with significant patient morbidity. This prospective case series investigated the use of PICO topical negative pressure therapy (TNPT) in addition to graduated compression therapy for VLU. Methods: Patients with VLU were recruited from a specialist vascular surgery clinic and treated with the novel combination of TNPT (PICO) underneath graduated compression therapy. Results: Twelve patients (15 VLUs) were treated over a median of 20 days (7-42). Median surface area reduced from 2.1 cm2 (1.1-5.8) to 0.8 cm2 (0.2-3.2) (p=0.022), and depth from 3.0 mm (1.8-3.3) to 0 mm (0-0) (p=0.005 Wilcoxon Signed-Rank Test). Time to heal was compared to a historical cohort with similar characteristics that was treated with compression therapy alone. The addition of TNPT was found to reduce time to heal from 6.3 to 4.3 weeks (p=0.024). Conclusion: This pilot study supports the benefit of combining TNPT (PICO) with compression bandaging to accelerate VLU healing.