Do you know how to treat venous leg ulcers?

What is a chronic leg ulcer?

Venous ulcers are ulcers with venous insufficiency, mainly caused by venous blood pooling in the lower extremities caused by peripheral vascular disease and venous return disorders. Ulcers often aggravate the pain due to infection and form a red and swollen area that is painful to the touch. A large amount of infectious exudation can also cause maceration and softening of surrounding skin tissue, resulting in adverse reactions such as odor and leakage, which affect the healing of ulcers and the life of patients. Venous leg ulcers are a common clinical disease, accounting for 70% to 90% of all leg ulcers. A venous leg ulcer is a typical chronic wound; pain and infection are the most common clinical manifestations of ulcer. 80% of people with leg ulcers have moderate to severe persistent or intermittent pain.

According to some statistics, about 7 million people in the United States suffer from venous insufficiency. These refractory ulcers have become a significant health problem affecting the quality of life due to the enormous cost of long-term treatment and the physical and mental discomfort caused by the ulcer. The annual cost of treating venous leg ulcers in the United States is estimated at $1 billion, with an average price of more than $40,000 per case.

How does venous disease cause ulcers?

It is due to the insufficiency of the deep venous valve, which leads to increased venous pressure and causes skin damage to the lower extremities, especially in the lower 1/3 of the calf, which we call the boot area. The size of the face varies, from one to two centimeters to ten centimeters, 20 centimeters are possible, and it is easy to recur in the same part, which will eventually lead to skin pigmentation, hard skin, dryness, scaling, and likely later Cords and fibrotic tissue appear around the wound, causing eczema and ulcers to occur on the surrounding skin. When combined with infection, the pain will be severe, and raising the affected limb can be appropriately relieved. The veins in the legs are the tubes that carry blood from the feet back to the heart. The veins in the legs have one-way valves that ensure that blood flows back up without regurgitation. For some people, if these valves are not functioning very well or have been damaged by venous thrombosis, blood can flow back down, causing very high venous pressure in the legs, long-term blood pooling, edema of the subcutaneous tissue and Hemosiderin oozes and so on, which can eventually damage the skin and cause ulcers.

How to treat venous ulcers?

Treatment of ulcer wounds:

1. Wound cleaning: There will be some necrotic substances, exudates, scabs. on the wound surface. It must be cleaned up in time. Otherwise, it will easily hinder wound healing. Generally, it is cleaned 1-2 times a day.

2. Rinse: General chronic leg ulcers will not have a severe infection. The wound cleaning solution can be rinsed with sterile water or normal saline. There is no need to rinse with strong irritating disinfectants such as alcohol or hydrogen peroxide, which will be very painful and affect the growth of fresh granulation tissue. When there are a lot of exudations from the wound or an attachment on the wound surface, the damage must be thoroughly cleaned. Using wound cleaning products containing surfactants can remove the dirt in the wound.

3. Dressings: Selection and use of dressings are selected for ulcer care according to the wound, patient needs, economic status, and availability. Venous ulcers should not be treated dry, but wet compresses are advocated. Studies have shown that wet wounds heal faster than dry ones, and closed wounds heal up to 40% faster than unclosed ones. A hydrogel or hydrocolloid dressing can reduce pain in people with ulcers. The moist environment can promote cell transfer, proliferation, and differentiation and form blood vessels and nerves. After washing the wound, covering it with hydrogel or hydrocolloid can accelerate wound healing.

Dressings can be selected according to the following criteria:

1) Maintain moderate moisturization of the wound and promote the healing of epidermal wounds, such as hydrogel or hydrocolloid dressings;

2) Dressings that can effectively manage exudate and protect the skin, such as alginate dressings, foam dressings;

3) Use non-adhesive wound dressings such as elastic self-adhesive bandages during bandage compression therapy.

How do avoid the recurrence of ulcers?

The healing of the ulcer does not mean the end. Although the appearance of the skin is intact, potential problems with the veins remain, and you must take precautions to prevent ulcers from recurring:

• Treatment of underlying venous problems (varicose veins, venous thrombosis, venous compression);

• ear compression stockings (or compression bandages) at all times during the day;

• Raise your legs as high as possible;

• Use moisturizing cream to prevent dry skin and keep skin healthy;

• Eating fresh fruit, exercising, and quitting smoking are all critical for ulcer healing and good health.

For more information on Innomed® hydrocolloid dressing please refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

Editor: kiki Jia
Date: June15,2022