Peripheral Calibrated Gradient Compression Pump for Treatment of Chronic Venous Leg Ulcers

Introduction: Venous leg ulcers (VLUs) can be a difficult to manage wound population, as the underlying vascular compromise can lead to continued peripheral edema and excessive drainage, which preclude ulcer healing. Calf muscle pump function and its failure may often confound healing in the lower leg wound. Many of these patients are not able to ambulate due to obesity and/or comorbidities. Therefore, replacing the function of the calf muscle pump with intermittent compression may serve to replace this function. Compression therapy has been a mainstay of VLU therapy, but generally is applied in dressing form. We looked at the use of a calibrated gradient compression pump (CGCP) in conjunction with multilayer compression therapy and its effects on healing chronic wounds.

Methods: Ten patients with VLUs that were over two months in age were dressed in triple layer compression and told to use a CGCP at home twice a day at a minimum pressure of 40 mmHg for 75 minutes. Wound size, characteristics, pain level, and leg circumference were measured weekly for up to eight weeks to see the effects of adjunctive CGCP at home.

Results: During each of the patient visits, we measured wound size and lower extremity circumference at the levels of the ankle, mid-calf, and upper calf. In the 10 patients treated with CGCP, there was a significant decrease in wound size and leg circumference.

Conclusion: At the end of four weeks, patients saw a reduction in leg circumference compared to the start of the study. Most patients saw a significant decrease in wound size, with many having complete wound healing. Most patients also noted decrease in exudate, odor, and pain after prolonged use. CGCP may be a useful adjunct in helping heal difficult VLUs in patients with significant lower extremity edema.