Introduction: Venous leg ulcers are the most severe manifestation of chronic venous insufficiency, and their treatment is based on compression therapy, whose effectiveness depends on the magnitude of the pressure and the biomechanical properties of the system. Doubts persist about the actual correlation between interface pressure, bandage stiffness and clinical outcomes in real-world practice. Objective: To compare the clinical efficacy and biomechanical behavior of different multicomponent compression systems in venous leg ulcers, analyzing the relationship between interface pressure, static stiffness, edema reduction and variation in the wound area. Methodology: This is a prospective, observational and multicenter study in six districts/health areas of Andalusia, in adults with active venous ulcers attended by Advanced Practice Nurses in Complex Chronic Wounds. Several multi-component compression systems were applied, and interface pressure was monitored using Tight Alright^® at three points on the leg for 96 h, recording final pressure, static stiffness, perimeters and ulcer area. Results: All systems achieved a reduction in leg circumference, more marked at the proximal points, evidencing an overall decongestant effect. The correlation between final pressure and edema reduction was weak, and relevant differences were observed in the reduction in ulcer area, with Urgo K2 and CPK Compress 2 standing out with decreases of more than 50% compared to medium or low yields of other systems with comparable pressures. The static stiffness analysis showed specific patterns according to system and leg size, as well as a heterogeneous longitudinal distribution of pressure. Conclusions: The efficacy of compression in venous ulcers depends on both the interface pressure and the design and biomechanical behavior of the system, with clinically relevant differences between multicomponent dressings. Multipoint pressure and stiffness monitoring provides useful information to optimize system selection and support decisions based on biomechanical parameters and standardized clinical outcomes.

Objective: To evaluate the effectiveness of different compression therapy (CT) systems for providing edema reduction, wound healing, and patient comfort during the treatment of venous leg ulcers (VLUs). Methodology: A multicenter study was carried out in four Andalusian provinces with 140 patients with active VLUs. The target population consisted of patients with active VLUs referred to the Advanced Practice Nurses in Complex Chronic Wounds APN-CCW during the study period, which ran from January 2024 to July 2025. The inclusion criteria were: VLU patients over 18 years of age, with an Ankle-Brachial Index between 0.9 and 1.3, and with exudate and scarring that would allow twice weekly dressing changes. The exclusion criteria were: Patients with wound types other than VLUs, with an inability to give informed consent, or with less than one year expected mortality. Patients were treated with 6 different types of compression therapy for 4 days, in accordance with manufacturers’ instructions. The pressures were monitored daily using a wearable pressure sensing device and connected digital platform. Leg circumference, RESVECH 2.0 score, mean improvement in wound condition, mean improvement in wound surface area average, and patient comfort level were analyzed. Results: CT significantly reduced edema, with a mean leg circumference reduction between 0.9 to 1.4 cm in four days. No differences were observed when grouping the participants by sex, age, or BMI. At the end of the study period, 21.4% of participants had achieved complete ulcer healing, and non-healed participants achieved a mean reduction of 2.6 points in the RESVECH scale. Although no statistically significant differences were found between the different compression systems, CPK Compress 2 and Urgo K2 showed the highest rates of healing, while Urgo K1 and Jobst Compri2 showed the lowest. This suggests possible variations in initial efficacy that merit further investigation. Patient comfort was highly satisfactory, with 93.8% of participants rating the compression as comfortable. The absence of significant differences in comfort across sex, age, obesity, or type of compression system, combined with the low number of bandage removals, reinforces the idea that CT is well tolerated and provides clear therapeutic benefits. Conclusions: The CT reduced edema and promoted healing in VLU patients, regardless of the compression system used. No significant differences were observed between compression systems in reduction of edema or healing outcomes. Patients reported high levels of comfort with all compression systems.

To measure and compare the temporal variations in sub‐bandage pressure compression systems in the Andalusian Health System (SAS). Additional objectives included assessing the relationship between pressure and healing, analysing the influence of the healthcare professional applying the bandage, and determining bandage stiffness. This prospective observational and multicentre study included 140 patients with active VLUs in Andalusia. Sub‐bandage pressures were measured at three anatomical points in the leg for 96 h, under different positions and activities. The bandage application technique was standardised through specific training provided to advanced practice nurses. The initial pressures were higher than those recommended by guidelines, but showed a notable reduction within the first 24 h, stabilising within therapeutic ranges for the remainder of the 96‐h study period. Most systems showed low dynamic and static stiffness. No significant pressure differences were found attributable to the nurses or the location of the injury. The observed pressure dynamics, initially high, with a subsequent drop and final stabilisation, suggest a high material settlement or application to compensate for the expected loss. The sustained pressure stability confirms the effectiveness of the systems over 96 h.