Use of Compression Therapy as Preventive Strategy for Recurrent Cellulitis on the Lower Legs

Vesna Brishkoska-Boshkovski; Mirela  Vasileva; Andrej Petrov

doi:10.3889/oamjms.2025.12034

Authors

Vesna Brishkoska-Boshkovski Department of Dermatology, Acibadem Sistina Clinical Hospital, Skopje, RN Macedonia; Department of Dermatology, Faculty of Medical Sciences, University Goce Delchev, Shtip, RN Macedonia https://orcid.org/0000-0002-1580-6117
Mirela Vasileva Department of Dermatology, Faculty of Medical Sciences, University Goce Delchev, Shtip, RN Macedonia; Department of Dermatology, Clinical Hospital Shtip, RN Macedonia https://orcid.org/0000-0002-6807-5557
Andrej Petrov Department of Dermatology, Acibadem Sistina Clinical Hospital, Skopje, RN Macedonia; Department of Dermatology, Faculty of Medical Sciences, University Goce Delchev, Shtip, RN Macedonia https://orcid.org/0000-0002-6859-7021

DOI:

https://doi.org/10.3889/oamjms.2025.12034

Keywords:

antibiotic prophylaxis, chronic leg oedema, compression therapy, lymphoedema, recurrent cellulitis

Abstract

BACKGROUND: Recurrent cellulitis of the lower limbs is a significant clinical challenge, with chronic oedema and impaired lymphatic function identified as key risk factors. While long-term antibiotic prophylaxis is commonly recommended, compression therapy has been proposed as a potential preventive measure, but evidence supporting its effectiveness remains limited.

AIM: This study aimed to evaluate whether compression therapy, in addition to standard antibiotic and supportive treatment, reduces the recurrence rate of cellulitis in patients with a history of recurrent cellulitis on the lower legs.

METHODS: A randomized controlled study was conducted over two years in a dermatology department. Seventy-three patients with a history of recurrent cellulitis were randomized into two groups: one receiving compression therapy along with standard antibiotic and supportive treatment (n=36) and a control group receiving only standard treatment (n=37). Patients were followed for two years to assess recurrence rates. Secondary outcomes included hospital length of stay and reduction in leg oedema. Data distribution was tested with the Shapiro-Wilk's W test. Qualitative data of patients with and without relapse were compared with non-parametric tests, quantitative data were compared with Student's t-test.

RESULTS: The recurrence rate was significantly lower in the compression therapy group (13.89%) compared to the control group (37.84%) (p=0.0197). Patients receiving compression therapy also had a significantly greater reduction in leg oedema by day four of hospitalization (p=0.005) and a shorter length of hospital stay (p=0.0006).

CONCLUSION: In this randomized controlled study, using the compressive therapy resulted in lower rate of cellulitis recurrence compared to the standard treatment of cellulitis. These findings support the inclusion of compression therapy in the management strategies for recurrent cellulitis. Further studies are warranted to reinforce these results and optimize treatment protocols.

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