THE EFFECTIVENESS OF LEG COMPRESSION THERAPY IN THE TREATMENT OF THE CELLULITIS PATIENTS: A SYSTEMATIC REVIEW

 

Y.H. CHANG1, H.C. Liao 1

1 nursing department, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

 

Introduction: Cellulitis is infection involving the deep dermis and subcutaneous tissue, is the most common reason for
skin-related hospitalization. Cellulitis presenting with expanding erythema, warmth, tenderness, and swelling. If it
progresses toosteomyelitis,necrotizing fasciitis can even lead to bacteremia, even easily lead to repeated admissions,
which in turn creates a huge medical burden. Studies have pointed out that patients with chronic edema Compression
therapy is used to prevent the recurrence of cellulitis. There is limited data on the economic cost, complications and
unnecessary utilization rates associated with cellulitis. Compression therapy can reduce the destruction of the skin barrier
caused by skin edema, and promote lymphatic drainage to improve immune function. We sought to determine the health
care burden of the impact of pressure therapy on cellulitis in an empirical way for future clinical care or recommendations.

Methods: First, keywords were identified for each step of following the PRISMA guidelines and PICO model. Medical
Subject Headings were used to conduct database searches for Chinese and English studies published before January
2023.Duplicate studies were removed and screening was performed according to the inclusion and exclusion criteria.
Finally, two randomized controlled trials (RCTs) were obtained, which were further evaluated using the Critical Appraisal
Skills Program RCT checklist and the Oxford Center for Evidence-Based Medicine levels of evidence.

Results: This is the analysis to demonstrate that compression therapy is a cost-saving treatment for cellulitis in patients
with recurrent and comorbid lower limb chronic edema. One of the studies showed that after 12 months of the study, the
average leg volume in the treatment group was a decrease with a mean gain of in the control group. Another results
showed that the annual medical service cost of the experimental group (receiving leg compression therapy) Compared
with the control group, the average total expenditure was reduced by 81%, showed that the benefit of leg compression
therapy.

Conclusion: In addition to for patients and health service perspective for patients with chronic edema and recurrent
cellulitis compression therapy provides many other health benefits. Advice is to further research with more participants
and a longer follow-up duration will allow for a robust analysis of its longer term cost-effectiveness.

References:

Webb, E., Neeman, T., Bowden F.J., Gaida, J., Mumford, V. ,Bissett ,B.(2020).Compression Therapy to
Prevent Recurrent Cellulitis of the Leg. The New England Journal of Medicine, 383(7),630-639.
https://doi.org/10.1056/NEJMoa1917197

Webb, E., Bissett, B., Neeman, T., Bowden, F., Preston, E.,Mumford, V.(2022).Compression Therapy Is Cost-Saving in
the Preventionof Lower Limb Recurrent Cellulitis in Patientswith Chronic Edema. Lymphatic Research and Biology, 1-9.
https://doi.org/10.1089/lrb.2022.0029