OBJECTIVE: To compare healing rates and associated treatment costs of four-layer high-compression bandaging (HCB) and conventional management (CM), as available on FP10, in the treatment of venous leg ulcers. DESIGN: Randomized prospective study in which patients were allocated to one of two treatment groups. SETTING: Hospital-based leg ulcer service and community. PATIENTS: Thirty-six patients presenting with venous leg ulcers (30 compliers): 16 patients (nine female) in the HCB group and 14 patients (10 female) in the CM group. INTERVENTIONS: A 12-week treatment period with either a four-layer HCB regime or CM. MAIN OUTCOME MEASURES: The significance of the difference between the number of ulcers healed, and associated treatment costs, was investigated using the Mann-Whitney U-test and survival analysis. RESULTS: Four-layer HCB achieves a significantly (p = 0.003) higher healing rate of ulcers (75% of patients versus 21%) over a 12-week period. Weekly treatment costs for the four-layer therapy was significantly less than that of CM (mean difference in cost Great British Pounds 6.45, 95% CI 1.22 to 11.68; p = 0.042). CONCLUSION: It is more efficacious and economical for nurse specialists to treat patients presenting with leg ulcers with a four-layer HCB regime than for district nurses to carry out the standard palliative treatments available on GP prescription form FP10.

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