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August 18, 2020
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Compression therapy may help prevent cellulitis in chronic leg edema

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Compression therapy resulted in a lower incidence of cellulitis than conservative treatment, according to a study published in The New England Journal of Medicine.

“Guidelines have suggested the use of compression therapy to prevent recurrent cellulitis in patients with chronic edema of the leg, and compression therapy is widely used by clinicians; however, there are limited data from trials to support this practice,” Elizabeth Webb, MPH, and colleagues wrote.

A single-center, randomized, nonblinded trial included 84 patients who were randomly assigned to receive leg compression therapy plus cellulitis prevention education or education alone.

Patients who had edema lasting longer than 3 months in one or both legs and two or more episodes of cellulitis in the same leg within 2 years were eligible for the study.

Both patient groups received education about cellulitis prevention at the first appointment, as well as information regarding skin care prevention and interdigital fungal infection prevention at subsequent appointments.

Those in the treatment group were instructed to wear compression garments throughout the day, the study said.

Recurrence of cellulitis occurred in six of the 41 participants (15%) in the compression group and 17 of 43 participants (40%) in the control group (HR = 0.23; 95% CI, 0.9 to 0.59; P = .002) at the time of the interim analysis. Three participants in the compression group and six in the control group were admitted to a hospital for cellulitis (HR = 0.38; 95% CI, 0.09 to 1.59).

A 0.5-point quality of life improvement was recorded in the compression group after 12 months compared with an improvement of 0.2 points in the control group.

“This single-center, nonblinded, randomized trial, which was stopped early for efficacy, showed that compression therapy resulted in a lower incidence of recurrent cellulitis than conservative treatment in adults with chronic edema of the leg,” the study authors wrote.

Longer and larger trials are recommended for more information on cellulitis recurrence.