What is the recommended procedure for treating leg ulcers?
It depends on the cause. If the ulcers are due to varicose veins, then treatment of the varicosities can help significantly in conjunction with a wound care specialist. If due to deep venous reflux, compression stockings and wound care are the best choices.
Published on Jul 11, 2012
Correct any superficial venous reflux.
Published on Jul 11, 2012
Venous stasis ulcers can be due to deep, superficial, and/ or perforator
vein incompetence; deep vein thrombosis can also be involved in the
etiology. Before recommending the "best" treatment, venous duplex scanning must be performed and a
comprehensive history and physical must be taken by an expert in the field of complex venous disorders. Perforator vein surgery (SEPS or RF ablation), superficial venous ablation, vein interruptions, or a combination of these treatments may be indicated.
Published on Jul 11, 2012
The best treatment for venous ulcers consists of 2 parts, both applied as
soon as possible. First, the underlying cause should be identified and
treated. Second, proper compression with edema reduction and specialized
wound care is needed until the ulcer heals.
Published on Jul 11, 2012
Venous ulcers need a multi-treatment approach. In addition to local wound care
and compression, the underlying cause of the venous ulcer must be addressed.
Most ulcers are caused by venous congestion related to "leaky" veins in your
legs. This condition is referred to as venous insufficiency. Treating the
venous insufficiency will not only help heal the ulcer, it will prevent
recurrence in the future.
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Venous ulcers are important and should have a clinic visit
Published on Jul 11, 2012
Venous ulcers usually require closure of the causative vein. This will heal the ulcer.
Published on Jul 11, 2012
Venous ulcers are wounds from any source (trauma, biopsy, bug bite) which fail to heal due to venous insufficiency and the edema which accompanies the problem. The higher than normal pressure in the superficial veins around the lower part of the leg, allows serum (water and protein) to seep through
the walls of the veins into the surrounding soft tissues. This fluid interferes with wound healing by making it difficult for oxygen to make it to the skin and also inhibits wound closing or contraction through outward
pressure. Diagnostic evaluation is the first step in determining whether there is something treatable, such as an incompetent saphenous vein. The superficial veins can be sealed if severe insufficiency is identified and this often facilitates more rapid closure of the venous ulcer. If the deep vein system is the problem, then therapy is typically conservative with compression hose or Unna boot wrap, elevation and ambulation with avoidance of prolonged sitting or standing. The key is to research and find an experienced vein specialist who recognizes that venous insufficiency is more than just varicose veins, and who has experience treating patients with venous ulcers.
Published on Jul 11, 2012
Depends on the cause of the ulcer. Sometimes an ablation procedure may be helpful though.
Published on Jul 11, 2012
Venous ulcer treatment is like a three legged stool. Compression, wound care and normalization of venous hypertension. See a phlebology specialist for evaluation and ultrasound.
Published on Jul 11, 2012
There is usually an underlying problem that is causing the ulcers. I would recommend an appointment for evaluation. In our office we do a complete evaluation, including an ultrasound, which looks at the underlying
veins and arteries. The ultrasound gives us a lot in information about the causes of ulcers. The evaluation is a covered benefit through insurance.
Published on Jul 11, 2012
You should first be fully evaluated by an experienced vascular surgeon with a standing ultrasound for deep and superficial system incompetence. Most commonly, they can be caused by superficial vein reflux. The ulcer should be evaluated for depth, infection and size/location to rule out arterial problems also. An appropriate dressing should be used and compression therapy started (if not arterial). There are several types of hose specifically for those with ulcers. A thigh length hose may be appropriate if reflux originates in the thigh. Even the traditional Unna boot works well to start the healing process. If using compression, they can be worn 24 hours per day and removed for bathing and dressing change. For saphenous reflux we recommend laser ablation with ultrasound guided sclerotherapy to veins in the area of ulceration, if indicated. Compression should be at least 30-40 or 40-50 mmHg pressure.
Published on Jul 11, 2012
We have had tremendous results from a combination of Laser Ablation and Compression therapy. For most venous ulcers we have skin coverage within 4-6 weeks.
Published on Jul 11, 2012
The patient needs a full evaluation of the venous circulation. If the patient has venous reflux (as most probably does), elimination of the venous reflux is crucial to help the healing and prevent recurrrent ulcers. The modalities to be used depend on the patient's anatomy of the venous system. Compression stockings are quite important as well.
Published on Jul 11, 2012
The best treatment for venous ulcers is to reduce the source of the venous hypertension causing the ulcer. This would require a thorough venous duplex exam to look at the GSV, LSV and perforators. Since the treatment of venous ulcers is a complex process, you should see someone who has experience treating these. Besides reducing venous hypertension via laser if necessary, long term treatment would be necessary with venous compression.
Published on Jul 11, 2012