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BACKGROUND: Publications demonstrate that conventional compression therapy in less than 47 % of cases with surgical stocking and less than 31 % with surgical bandage leads to the required edema reduction in chronic venous insufficiency. Therefore other forms of treatment are required. PATIENTS AND METHODS: We present a procedure for treatment-resistant leg ulcers using daily adaptable compression. Twenty-five patients who had chronic venous insufficiency with non-healing leg ulcers and/or massive edema over a period of several decades were treated for a period of about 5 months. The patients wore a segmental-circular-adaptive lower leg sleeve closed dorsally. At the dorsum of the foot and in the ankle area the sleeve has six 2 cm wide tapes with Velcro fasteners, in the proximal area until below the knee it has five 5 cm wide straps which generate a compression by tensile force that is adaptable as required. This compression can be adjusted daily for each segment. RESULTS: After 1 day, the median of the following reduced leg circumferences were achieved in 4 areas: from 53 to 48 cm (dorsum of the foot), from 44 to 43 cm (ankle), from 36 to 33 cm (calve), from 27 to 26 (below the knee). In case of all patients with therapy resistant necrotizing, progressive ulcerations, these were completely healed. The acceptance of the procedure with the patients was very good. CONCLUSION: The precise segmental compression sleeve leads to the heeling of therapyresistent venous leg ulcers.

Neue, erfolgreiche Therapie beim venösen Ulcus cruris mit der segmental-adaptiven Kompressionsmanschette (SAKM)