A Cochrane review included 48 studies reporting 59 comparisons with a total of 4 321 subjects. There was evidence from 8 studies (unpooled) that healing outcomes (including time to healing) were better when patients received compression compared with no compression.
Single-component compression bandage systems was less effective than multi-component compression for complete healing at 6 months (1 large study). A two-component system containing an elastic bandage healed more ulcers at 1 year than one without an elastic component (1 small study). Three-component systems containing an elastic component healed more ulcers than those without elastic at 3 to 4 months (RR 1.83, 95% CI 1.26 to 2.67; 2 studies), but another study showed no difference between groups at 6 months. An individual patient data meta-analysis of 5 studies suggested significantly faster healing with the four-layer bandage (4LB) than the short stretch bandage (SSB): median days to healing estimated at 90 and 99 respectively (HR 1.31, 95% CI 1.09 to 1.58). High-compression stockings were associated with better healing outcomes than the short stretch bandage at 2 to 4 months (RR 1.6, 95% CI 1.26 to 2.10; 4 studies).