Adding Aspirin to Compression Therapy May Hasten Venous Ulcer Healing

DynaMed Weekly Update - Volume 7, Issue 20

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Venous ulcers are a common complication of venous insufficiency and are usually treated with compression therapy. Compression is usually effective for healing, but the recurrence rate can be high. Aspirin was found to help with ulcer healing in a small trial with 20 patients in 1994, but there were no follow-up trials, and current guidelines conclude there is insufficient evidence to recommend aspirin use for venous ulcers. Now, a second randomized trial has investigated the effects of adding aspirin to compression on healing time and recurrence rates. A total of 51 patients (mean age 60 years) with ulcers > 2 cm associated with chronic venous insufficiency were randomized to aspirin 300 mg/day vs. no aspirin. All patients received wound care including cleaning, debridement, and hydrocolloid dressings followed by compression therapy with a 2-layer system providing cushioning and continuous pressure. No topical corticosteroids or antiseptics were used. Patients received antibiotics for infected lesions. Exclusion criteria included diabetes, rheumatoid arthritis, peripheral arterial disease, neurological disease, and contraindications to aspirin.

The mean time to healing was 12 weeks for aspirin and 22 weeks for no aspirin (p = 0.04) (level 2 [mid-level] evidence). The recurrence rates of 25% for aspirin and 33.3% for no aspirin were not significantly different. The mean time to ulcer recurrence was significantly increased in the aspirin group (39 days vs. 16.3 days, p = 0.007) (Ann Vasc Surg 2012 Mar 19 early online). While this trial is also small, the cost and risks associated with aspirin use are low.

For more information, see the Venous ulcer topic in DynaMed.