Treatment of Venous ulcers

Venous ulcers, also known as stasis leg ulcers, are shallow wounds that develop on the skin when the leg veins don’t return blood back towards the heart as they should. Chronic venous insufficiency leads to a breakdown of tissue and the formation of a venous ulcer. Typically, venous ulcers develop on the sides of the leg above the ankle and below the calf.

The goal of venous ulcer treatment is to promote healing of the ulcers, reduce swelling, and prevent or treat infection. Tests are performed in order to determine which treatment of venous ulcers meets your specific needs. The larger the ulcer, the longer it will take to heal.

The most common way to treat venous ulcers is to elevate the legs and use compression stockings. Compression stockings help to control painful swelling from fluid build-up and alleviate circulation problems. Those who follow a long-term compression regimen tend to get the best results from additional treatments. You can also prevent venous ulcers from returning by wearing compression stockings during the day and elevating your legs as often as possible.

Treatment

Compression Stockings – A dressing is placed over the ulcer before you put the compression stockings on. The dressing may contain medicine to speed the ulcer’s healing.

Multi-Layer Compression Wrap – Consisting of three to four layers, this compression wrap is wrapped from the toes to just below the knees. The first layers serve to pad and control drainage, while the outer layers provide compression. In the early weeks, when the ulcers drain heavily, the wrap may need to be changed more often.

Leg Elevation – Three to four times a day for 30 minutes a day, elevate your legs above the level of the heart using pillows or a foam wedge. Elevation is an important part of treating venous ulcers, but don’t take that to mean that you should rest and elevate your legs all day long. Stay as active as you can, and avoid standing for prolonged periods.

Debridement – Debridement involves the removal of dead tissues on the venous ulcer. It is used to ensure proper healing.

Antibiotics – Antibiotics are prescribed for a short period if the skin and tissues around the ulcer become infected. Antibiotics do not affect the healing process in any way.

Skin Grafting – For deep or longstanding ulcers that haven’t healed, skin grafting is an effective treatment option.

Surgery – The goal of surgery is to remove the superficial veins that cause the blood to pool and block the supply of nutrients to the skin. Surgery for the treatment of venous ulcers is performed under general anesthesia. We will determine whether you are a candidate for surgery by examining the skin around your ulcer while you are in standing position.

Intermittent Pneumatic Compression (IPC) pump – IPC pumps alternate between inflating and deflating knee high boots in order to minimize the pooling of blood in the legs. IPC pumps are used at home when compression has failed to heal the ulcers.

Pentoxifylline – Pentoxifylline is an oral medication that speeds the healing of ulcers when used in conjunction with compression treatment.