Effect of Unna's boot on venous ulcer healing: a systematic review and meta-analysis.
Fernanda Peixoto Cordova, Ana Claudia Furhmann, Andreia Cristina Feitosa do Carmo and 6 others
PMID 39221989WHAT IT FOUND
Unna's boot did not heal venous ulcers better than other compression therapies.
It appeared better than non-compression usual care in one study, but the evidence was limited and biased.
Key findings
01Only one of four healing-rate studies using Unna's boot found it superior, and that study compared it with usual care.
02In comparisons with other compression therapies, the reported healing-rate ratios were 1.02, 0.88 and 1.20. In one multi-arm study, Unna's boot had a lower number of ulcers healed than pneumatic compression, Ulcer X and multilayer short-stretch bandages.
03No superior effect on time to healing was identified in the three Unna's boot studies, and only one of four Unna's boot studies showed superior ulcer-area reduction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not pool all studies because healing was measured in different ways. Only five studies compared the same compression therapies, so heterogeneity assessment was limited. Publication bias could not be assessed because few studies shared the same intervention. Many trials were at high risk of bias, often because blinding of outcome assessment was not reported or was not possible. Cohort and case-control studies were rated as having serious risk of bias. Some studies had short follow-up and limited numbers of patients. The review included only English, Portuguese and Spanish studies, and some full texts were not freely available.
Declared interests
The study was funded by CNPq and Fapergs. The Unna's boot compression therapy was donated by Casex Innovation in Healthcare, which the authors state did not interfere with study design, data collection, analysis, interpretation, writing or publication.
The easy way to misread this
Do not conclude that Unna's boot is better than other compression therapies. It was superior in only one of four healing-rate studies, and that study compared it with usual care, not another compression system.