Compression therapy is the most important treatment modality for venous leg ulcer healing and prevention of recurrence.

Therapy is applied mainly by bandages or hosiery, with the highest pressure applied at the ankle and with the pressure gradually reduced towards the knee as the circumference of the limb increases towards the calf.

The underlying principles of compression therapy are: A larger limb circumference results in lower sub-bandage pressures. Applying the highest pressure at the ankle encourages venous return and, therefore, decreases venous hypertension and reduces oedema.

Compressing the calf enhances the action of the calf muscle pump. Recently however there have been some questions about the principle of graduated compression.

The aim of this article is to look at recent research in this area of leg ulcer management.