ABSTRACT
Patients with healed ulceration of the legs, whether venous or arterial in origin, are liable to develop breakdown and recurrent ulcers. Previously ulcerated skin is never as stable as normal skin and it is important to prevent even minor trauma. Recurrence has been reported in one-quarter of patients with healed venous leg ulcers within the first year.1 This is clearly an important economic problem but remains one that is difficult to address successfully. The use of compression hosiery is effective in preventing recurrence of ulceration following healing. This applies whether healing was achieved using compression alone or following surgical treatment for superficial and perforating vein incompetence. Class 2 or 3 below-knee compression stockings are effective in reducing recurrence. However, many elderly patients find considerable difficulty in applying stockings or find them uncomfortable. It has been found that patients who are unwilling or unable to comply with advice to wear compression hosiery are at greatest risk of further leg ulceration.1 This problem will continue to be a significant drawback to the use of one of the most effective measures in healing and preventing the recurrence of venous leg ulcers. Various devices are now available which simplify the application of compression stockings (see Ch. 25, p. 230) but these are only used on a limited scale.
