Tag: Venous leg ulcer

Compression therapy for venous leg ulcers

Compression therapy is the mainstay of treatment of venous leg ulcers (VLU). Good wound care and compression therapy will heal majority of small venous ulcers of short duration.[] Goals of compression therapy are ulcer healing, reduction of pain and edema, and prevention of recurrence.[] Compression is used for VLU and narrows veins and restores valve competence and reduces ambulatory venous pressure, thus reducing venous reflux (VR). It also helps decrease inflammatory cytokines, accelerates capillary flow, and lowers capillary fluid leakage thereby alleviating limb edema. It also softens lipodermatosclerosis, improves lymphatic flow and function, and enhances fibrinolysis.

 

Indications

The aim of compression therapy is to improve the venous function without compromising arterial function.

 

Contraindications

The contraindications of compression therapy are the following[,]

  • Advanced peripheral obstructive arterial disease (ankle brachial pressure index [ABPI] <0.8) (Evidence level A)
  • Systemic arterial pressure <80 mm Hg at ankle
  • Phlegmasia cerulea dolens
  • Uncontrolled congestive heart failure
  • Abscesses
  • Septic phlebitis
  • Advanced peripheral neuropathy.

read more

Venous stasis ulcers, arterial ulcers, diabetic neuropathic ulcers, pressure …

Are You Confident of the Diagnosis?

 

Leg ulcers are skin lesions with full-thickness loss of epidermis and dermis on the lower extremities. Among a wide variety of etiologies for chronic leg ulcers, four common types are venous stasis ulcers, arterial ulcers, diabetic neuropathic ulcers, and pressure ulcers. By definition, chronic leg ulcers last greater than 6 weeks. Acute ulcers such as traumatic wounds undergo normal healing in healthy patients without the need for further treatment. As a result, only chronic leg ulcers will be discussed here.

 

Patients with venous leg ulcers commonly complain of swelling and aching of the legs that is worse at the end of the day and improves with leg elevation. The medial lower leg is the most common site. The borders of venous ulcers are typically saucer-shaped, initially with a shallow wound base. The surrounding skin often exhibits pitting edema, induration, hemosiderosis, varicosities, lipodermatosclerosis, atrophie blanche, and/or stasis dermatitis read more

 

Reducing infection in chronic leg ulcers with an activated carbon cloth dressing

Chronic wounds are likely to have an increased bioburden, which in turn increases the risk of local infection. Indeed, infection is one of the most frequent complications of non-healing wounds, resulting in longer treatment times, increased risk of morbidity, greater resource use (of both dressings and nurse time) and, most importantly, a high personal cost to patients and their families (Cooper et al, 2014). While the ultimate aim is to treat the underlying wound, use of antimicrobial dressings is the cornerstone of the treatment of infected wounds. Most antimicrobial dressings work by killing the bacteria, and are indicated for use only when there are clear signs of increased bioburden and/or clinical signs of infections. As such, their use is assessed after 2 weeks, at which point it is advised that the clinician switches to another type of dressing if the wound is observed to be healing (Cooper et al, 2014) … read more