***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Venous  ulcers  affect up to 1 % of the population . This review provides the hemodynamic , hematologic and clinical effects of intermittent pneumatic compression ( IPC ) in the treatment of venous ulcers . It presents the different IPCs and their application on venous disease . It points out that a large r and omized study on IPC versus st and ard four-layer compression in the treatment of venous ulcers is needed . The cost-effectiveness of IPC  in the treatment of venous ulcers should also be assessed BACKGROUND Intermittent pneumatic compression ( IPC ) has been successfully used in the treatment of  venous ulcers  , although the optimal setting of pressure , inflation and deflation times has not yet been established . The aim of this study was to compare the effect of two different combinations of IPC pump setting s ( rapid vs slow ) in the healing of venous ulcers . MATERIAL / METHODS 104 patients with pure venous ulcers were r and omized to receive either rapid IPC or slow IPC for one hour daily . The primary and secondary end points were the complete healing of the reference ulcer and the change in the area of the ulcer over the six months observational period , respectively . RESULTS Complete healing of the reference ulcer occurred in 45 of the 52 patients treated with rapid IPC , and in 32 of the 52 patients treated with slow IPC . Life table analysis showed that the proportion of ulcers healed at six months was 86 % in the group treated with the fast IPC regimen , compared with 61 % in the group treated with slow IPC ( p=0.003 , log-rank test ) . The mean rate of healing per day in the rapid IPC group was found to be significantly faster compared to the slow IPC group ( 0.09 cm2 vs 0.04 cm2 , p=0.0002 ) . CONCLUSIONS Treatment with rapid IPC  healed venous ulcers more rapidly and in more patients than slow IPC . Both IPC treatments were well tolerated and accepted by the patients . These data suggest that the rapid IPC used in this study is more effective than slow IPC in venous ulcer healing OBJECTIVE It has been previously shown that the SCD Response Compression System , by sensing the postcompression refill time of the lower limbs , delivers more compression cycles over time , result ing in as much as a 76 % increase in the total volume of blood expelled per hour . Extended indications for pneumatic compression have necessitated the introduction of portable devices . The aim of our study was to test the hemodynamic effectiveness of a new portable sequential compression system ( the SCD Express ) , which has the ability to detect the individual refill time of the two lower limbs separately . METHODS This was an open , controlled trial with 30 normal volunteers . The new SCD Express was compared with the SCD Response Compression System in the supine and semirecumbent positions . The refilling time sensed by the device was compared with that determined from velocity recordings of the superficial femoral vein using duplex ultrasonography . Baseline and augmented flow velocity and volume flow , including the total volume of blood expelled per hour during compression with the SCD Express , were compared with those produced by the SCD Response compression system in the same volunteers and positions . RESULTS Both devices significantly increased venous flow velocity as much as 2.26 times baseline in supine position and 2.67 times baseline in semirecumbent position ( all P < .001 ) . There was a linear relationship between duplex ultrasonography-derived refill time and the SCD Express-derived refill time in both the supine ( r = 0.39 , P = .03 ) and semirecumbent ( r = 0.71 , P < .001 ) positions but not with the SCD Response . Refill time measured by the SCD Express device was significantly shorter and the cycle rate higher in comparison with the SCD Response in both positions . The single-cycle flow velocity and volume flow parameters generated by the two devices were similar in both positions . However , median ( interquartile range ) total volume of blood expelled per hour was slightly higher with the SCD Express device in the supine position ( 7206 mL/h [ range , 5042 - 8437 ] vs 6712 mL/h [ 4941 - 10,676 ] ; P = .85 ) and semirecumbent position ( 4588 mL/h [ range , 3721 - 6252 ] vs 4262 mL/h [ 3520 - 5831 ] ; P = .22 ) . Peak volume of blood expelled per hour by the SCD Express device in the semirecumbent position was significantly increased by 10 % in comparison with the SCD Response ( P = .03 ) . CONCLUSIONS Flow velocity and volume flow enhancement by the SCD Response and SCD Express were essentially similar . The latter , a portable device with optional battery power that detects the individual refill time of the lower limbs separately , is anticipated to be associated with improved overall compliance and therefore optimized thromboprophylaxis . Studies testing its potential for improved efficacy in preventing deep vein thrombosis are justified Intermittent pneumatic leg compression ( IPC ) increases arterial calf inflow and foot skin blood flux in normal subjects and claudicants . Our hypothesis was that IPC could enhance foot skin blood flux after infrainguinal grafting and thus promote distal perfusion in limbs with tissue loss . The aim of this study was to compare the effects of three IPC modes [ applied to the foot ( IPCfoot ) , the calf ( IPCcalf ) , or both ( IPCfoot+calf ) ] on foot skin perfusion in healthy individuals , claudicants , and patients after infrainguinal arterial revascularization performed for critical or subcritical limb ischemia . Altogether , 20 healthy limbs , 22 claudicating limbs , and 36 limbs of arteriopaths with prior successful autologous femoropopliteal and femorodistal ( 18 each ) grafts were examined . Five-minute laser Doppler recordings were obtained from the pulp of the big toe in the sitting position , at rest , and during r and om applications of IPCfoot , IPCcalf , and IPCfoot+calf delivered at 120 mmHg for 4 seconds three times per minute . Foot skin blood flux increased using all IPC modes ( p < 0.001 ) , with IPCfoot and IPCfoot+calf generating higher flux levels than IPCcalf ( p < 0.01 ) in all groups . Intergroup differences of flux with each of the three IPC modes were not significant . IPCfoot and IPCfoot+calf similarly ( p > 0.14 ) produced a higher percentage flux increase than IPCcalf in all groups ( p < 0.004 ) . Controls had a higher percentage flux increase with both IPCcalf and IPCfoot than did claudicants ( p ≤ 0.016 ) . No differences were documented between normal and grafted limbs ( p > 0.05 ) . The percentage flux increase with IPCfoot+calf and IPCcalf was significantly higher in femorodistal grafts than in femoropopliteal ones ( p ≤ 0.026 ) . IPC enhances skin blood flux in limbs with infrainguinal bypass , claudication , and normal arteries , with IPCfoot and IPCfoot+calf being more effective than IPCcalf . Our findings suggest that IPC may be beneficial in limbs with impaired distal perfusion and thus may have clinical implication s in the treatment of leg ulcers either prior to or after revascularization BACKGROUND The purpose of the present paper was to compare healing rate and leg swelling with an intermittent compression pump versus compression b and ages in the treatment of  venous leg ulcers  , and to also compare patient compliance and satisfaction with the two techniques . METHODS A r and omized cross-over study of patients attending an outpatient wound clinic ( n = 16 ) was undertaken . A regular monthly follow-up with measurement of ulcer size and leg volume was carried out , as well as completion of a question naire . RESULTS Assessment was possible in 11 of the 16 patients . There was no significant difference between treatment types with regards to ulcer healing rates or control of leg oedema . The survey revealed that patients found the pump easier and more comfortable to use , with a trend towards increased compliance . CONCLUSIONS Although the present study was too small for generalizable conclusions , compression pumps and b and ages are comparable in efficacy for the healing of venous leg ulcers . The compression pump is reported as being easier and more comfortable to use than b and ages OBJECTIVES To test the hypothesis that the SCD EXPRESS intermittent pneumatic compression applied in combination with a four-layer b and age in patients with venous ulcers increases popliteal vein volume flow and velocity . DESIGN Twenty limbs of 18 patients with venous leg ulcers were studied , median age 76 years . The Total Volume Flow ( TVF ) and the Peak Systolic Velocity ( PSV ) were recorded in the popliteal vein using duplex ultrasonography . Measurements were made ( i ) without b and age , ( ii ) with four layer b and age and ( iii ) following the application of the SCD Compression System on top of a four-layer b and age for at least 15 minutes . RESULTS The median VCSS was 17 ( range , 12 - 22 ) while the median VSDS for reflux was 4.5 ( range , 1 - 7.5 ) . The median TVF was 71 mL/min ( inter-quartile range 57 - 101 ) without b and age , 112 ( IQR 89 - 148 ) with four-layer b and age and 291 ( IQR 241 - 392 ) with the addition of the SCD System ( P<.001 , Wilcoxon signed ranks test ) . The median PSV was 8.4 cm/sec ( IQR 6.8 - 14 ) without b and age , 13 ( 9.0 - 19 ) with four-layer b and age and 27 ( 21 - 31 ) with the addition of the SCD System ( P<.001 , Wilcoxon signed ranks test ) . Both TVF and PSV increased slightly with the addition of the four-layer b and age . However , with the addition of the SCD System these parameters increased three fold . CONCLUSIONS The SCD EXPRESS Compression System accelerates venous flow in the legs of patients with venous ulcers already treated with a four-layer b and age . The combination of four-layer compression with the SCD System on healing venous ulcers needs to be tested by a clinical effectiveness study Compression therapy -- including inelastic , elastic , and intermittent pneumatic compression -- is the st and ard of care for venous ulcers ( VLUs ) and chronic venous insufficiency , but there is no consensus in the literature regarding the most effective type of compression therapy . A prospect i ve , r and omized , clinical pilot study was conducted among 70 patients with unilateral VLUs treated in a hospital dermatology department in Pol and to compare three types of compression therapy ( intermittent pneumatic compression , stockings , and short-stretch b and ages ) in persons with superficial deep venous reflux alone or combined with the segmental variety . Study endpoints were change in ulcer dimensions and proportions healed .  Patients with superficial or combined superficial and deep vein insufficiency were r and omly allocated to receive one of the three therapies ( one of each vein type for each treatment option , six groups total ) . All patients received saline-soaked gauze dressings along with micronized purified flavonoid fraction , diosmin , hesperidin , and Daflon 500 once daily . Compression treatments were changed or pneumatic compression provided daily for 15 days . Wound size reduction and percentage of wounds healed were significantly higher in groups receiving intermittent pneumatic compression or stockings than in groups using short-stretch b and ages ( for percentage change of ulcer surface area , P = 0.02 ; for healing rates P = 0.01 ) . These results warrant additional r and omized controlled clinical studies with a larger sample size and longer patient follow-up BACKGROUND A number of different treatment approaches have been recommended for the treatment of venous ulceration , including local ulcer treatment , compression and drug therapy . Recent advances in tissue engineering have result ed in living tissues being developed for cutaneous wound repair and skin replacement . The aim of this pilot study was to compare the rate of healing of venous ulcers in patients treated with Dermagraft ( a human fibroblast-derived dermal replacement ) and compression therapy or compression therapy alone . METHODS A total of 18 patients with venous ulceration of the leg were recruited into the pilot study . Ten patients were treated with Dermagraft and compression therapy , and eight patients were treated with compression therapy alone .  Healing was assessed by ulcer tracing and computerised planimetry . Skin perfusion was measured by laser Doppler . RESULTS Five ( 50 % ) of the patients treated with Dermagraft and one ( 12.5 % ) control patient had healed by the end of the 12-week study period ( NS ) . The total ulcer area rate of healing and linear rate of healing was significantly improved in patients treated with Dermagraft ( P=0.001 and P=0.006 , respectively , Mann-Whitney U-test ) . The number of capillaries increased in both the treatment and control group . Peri-ulcer skin perfusion increased by 20 % in patients treated with Dermagraft , compared with 4.9 % in the control group . CONCLUSION The data from this small pilot study suggests that Dermagraft is associated with improved healing of venous ulceration . Following this pilot study , further clinical studies are needed to confirm the validity of these results in ' hard to heal ' venous leg ulcers Despite improvements in healing rates  venous ulcer disease still carries significant morbidity and cost . Any therapy that further improves healing rates is worthy of consideration . The recognised effects of intermittent pneumatic compression ( IPC ) on both arterial and venous 
    Output:
    
IPC may increase healing compared with no compression .
It is unclear whether it can be used instead of compression b and ages .
There is some limited evidence that IPC may improve healing when added to compression b and ages .