OBJECTIVE: To assess the effect of elastic stockings on reducing the area of lipodermatosclerosis in patients with healed venous ulceration. DESIGN: Patients in this study were part of a randomized controlled trial to assess elastic stockings in preventing venous ulcer recurrence. SETTING: Leg ulcer clinic at a tertiary teaching hospital. PATIENTS: Consecutive consenting patients with leg ulcers due to venous disease alone, that had healed 2 weeks previously. INTERVENTIONS: Patients were randomized to below-knee graduated compression stockings (Venosan 2003) or no stockings. MAIN OUTCOME MEASURES: patients had the area of lipodermatosclerosis measured on admission to the study and at 6-month intervals. Time to ulcer recurrence was also recorded for a 2-year follow-up period. RESULTS: One hundred and fifty-three patients were randomized to the main study (stockings 72, no stockings 81); 52 had re-ulcerated by 6 months (15 stockings, 37 no stockings). Lipodermatosclerosis was significantly reduced after 6 and 12 months in those patients wearing stockings but not in the control group (repeat measures ANOVA p = 0.01, p = 0.04). The initial area of lipodermatosclerosis was significantly larger in those patients who re-ulcerated within 2 years of entering the study compared with those who did not re-ulcerate (re-ulceration, 293 cm2; no re-ulceration, 50 cm2). CONCLUSIONS: Elastic stockings alone can improve the skin changes of lipodermatosclerosis and lower the rate of ulcer recurrence.

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