Chronic leg ulcers in patients with sickle cell anemia: Experience with compression therapy in Nigeria

Objective/Purpose: A pilot study to assess the efficacy of compression therapy on the healing rate of chronic leg ulcers (CLUs) in patients with sickle cell anemia (SCA) in Nigeria. Materials and Methods: A cohort study of patients with SCA and CLU complication was conducted using simple random sampling method to enroll patients from communities in Ibadan, Oyo State, Nigeria. A total of 18 patients with SCA having a total of 25 chronic leg ulcers and ankle brachial pressure index >1 were treated with a high compression bandage of four layers on a weekly basis after wound assessment for a period of 3 months. Wilcoxon signed-rank test was used to compare wound area at pre- and postintervention. Results: The enrolled patients with SCA were in the age range of 19–44 years, and mean ± SD was 28.8 ± 6.5 years. The initial median ulcer size was 38.4 cm2 (range 0.5–416 cm2); 21 leg ulcers (84%) were >10 cm2 in size at the beginning of the study. These leg ulcers had been present for a median age of 7 years (range 1–22 years). The compression therapy technique achieved >50% healing rate in 16 legs (64%) with an initial ulcer size of 0.5–312 cm2. Four leg ulcers (16%) were completely healed during the study. The postintervention median ulcer size was 18.6 cm2 in all the 25 leg ulcers studied (P < 0.001). Conclusion: Compression wound therapy promotes a positive healing rate of the CLUs in patients with SCA in Nigeria.