Does compression help venous leg ulcers?

Yes. Wear compression stockings or bandages every day as instructed; they help prevent blood from pooling, reduce swelling, help with healing, and reduce pain. But don’t use compression on an arterial ulcer unless a provider says so.

Yes, and it does four things. Wear compression stockings or bandages every day as instructed. They help prevent blood from pooling, reduce swelling, help with healing, and reduce pain.

It is not optional or an extra. To help treat a venous ulcer, the high pressure in the leg veins needs to be relieved, and compression is the first step toward that.

It is also part of the dressing routine rather than separate from it: you will wear a compression stocking or bandages over the dressing, and your provider will show you how to apply the bandages.

Why it works follows from the cause. A venous ulcer forms because the one-way valves in the leg veins become weak or the veins become scarred and blocked, so blood flows backward and pools, raising pressure in the lower leg veins. Compression is aimed at the pooling.

Compression is not the whole treatment. Other steps include putting your feet above your heart as often as possible, taking a walk or exercising every day, and taking medicines as directed. If ulcers do not heal well, your provider may recommend certain procedures or surgery to improve blood flow through your veins.

The important limit is that this answer belongs to venous ulcers. For ischemic ulcers, the wounds caused by poor arterial blood flow, the advice is the opposite: do not wear compression stockings or wraps unless told to by your provider. These may restrict blood flow. The same treatment that is used daily for a venous ulcer is something to avoid on an arterial one without instruction.

Which wound you have is therefore not a detail. It decides whether compression is the treatment or the warning, and it is established by an exam.

What to watch for

With ischemic (arterial) ulcers: do not wear compression stockings or wraps unless told to by your provider. These may restrict blood flow. Compression prescribed for one leg wound is not automatically right for another.

Your provider will show you how to apply the bandages, which is a reason not to improvise application at home.

Signs of infection to contact a provider about: redness, increased warmth, or swelling around the wound; more drainage than before or drainage that is yellowish or cloudy; bleeding; odor; fever or chills; increased pain.

If ulcers do not heal well, your provider may recommend certain procedures or surgery to improve blood flow through your veins.

Wound Wizard is general education and cannot assess your leg. Your own clinician is the right person to ask.

What we look at

  • Identifying the type of wound and what caused it
  • Checking the blood flow before compression is used
  • Fitting compression and showing you how to apply it
  • Reviewing the leg while compression is worn

Sources

  1. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm
  2. Ischemic ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000742.htm