CLINICAL INSIGHTS

What keeps venous leg ulcers from healing?

Chronic venous insufficiency can cause valves in the leg veins to stop working properly. These damaged veins may lead to complications such as varicose veins, pressure, swelling and skin breakdown with open sores known as venous leg ulcers (VLU).

Typically occurring on legs or ankles, VLUs may be hard to identify, especially if a person’s medical history is unclear. If not assessed correctly, inadequate treatment may delay healing. Even after a VLU has been identified, other challenges can prolong healing times, including:

1. Lack of proper skin care, often a result of patients and caregivers not using the right products consistently
2. Patient non-adherence due to misunderstandings, as well as physical, psychological and other hardships
3. Risk of infection from biofilm in chronic wounds

Together, we help clinicians and patients overcome venous stasis challenges with evidence-based best practices and the right system of products.

Illustration of foot with wound
Up to 50% of VLUs remain unhealed at 6 months¹

Protect intact skin from breakdown

While managing venous ulcers, it’s important to maintain proper skin care. Use nutrient-rich skin care products and follow these important steps:

  1. After removing compression wraps, wash the leg thoroughly, rinse and dry completely. This cleansing routine gives you an opportunity to inspect the wound as well.
  2. Gently moisturize intact skin around the wound.
  3. If there’s drainage, use a moisture-barrier product, as fluids can cause damage to skin around the wound.
Gloved hands applying Remedy Hydraguard to individual

Keep skin moisturized

Moisturize with 12.5% dimethicone to help soothe fragile skin and resist moisture loss.

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Clinician applying Remedy Calazime to individual

Create a strong barrier

Build lasting protection with a paste that contains an effective combination of zinc-oxide and white petrolatum.

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Control the underlying venous disease

Compression therapy helps blood move, reduces pressure in the veins and decreases swelling. That’s why it’s considered the gold standard for managing chronic venous insufficiency symptoms and venous leg ulcers.

But people sometimes find compression uncomfortable or disruptive to their lives, and they give up. That’s when VLUs can recur. How can you help ensure compression is successful?

  • Choose a compression device that’s effective, easy to apply, breathable and comfortable.
  • Educate patients on the importance of self care.

Keep in mind, if a person complains of pain with compression, stop and reassess the situation. You could be dealing with an arterial wound, which would not be right for compression.

Clinician applying AccuWrap to leg, with inset showing accuracy indicator

Achieve accurate compression

A 2-layer system with accuracy indicators makes it easier for clinicians to achieve optimal pressure.

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Individual wrapping leg with COMPRECARES compression device

Encourage patient compliance

At-home compression devices with AccuTabs are more comfortable, simple to apply and help improve quality of life.

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Improve healing time with the right tools

Treating a hard-to-heal venous ulcer starts by removing wound exudate. Look for an advanced wound dressing that effectively absorbs drainage. If there’s no progress after about two weeks, try gentle debridement with a concentrated surfactant, which can work under the dressing.

Remember that biofilm can delay chronic wound healing, so be armed with a hard-working antibacterial foam dressing.

Close-up view and inset of Medline Opticell dressing

Reduce exudate

Create a strong, absorbent and conformable gel with a dressing that contains chitosan.

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Gloved hand holding IoPlex dressing over small wound

Manage infection

Improve infection management through slow-release iodine within the wound dressing.

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RELATED CONTENT

Learn more about caring for venous stasis

Clinician showing compression wrap to patient

Get 3 proven ways to encourage patient adherence

Headshot of Dr. Terry Treadwell

Dr. Terry Treadwell discusses the why, when and how of compression

Overlapping thumbnails of wound education posters

Help caregivers distinguish VLUs from other lower extremity wounds

References:

  1. TTreadwell, T., Sabolinski, M. L., Skornicki, M., & Parsons, N. B. (2018). Comparative Effectiveness of a Bioengineered Living Cellular Construct and Cryopreserved Cadaveric Skin Allograft for the Treatment of Venous Leg Ulcers in a Real-World Setting. Advances in Wound Care, 7(3), 69–76. Available at https://doi.org/10.1089/wound.2017.0738