Treatment of Venous Stasis Ulcers

Venous ulcers are very resistant to treatment and require a lot of patience and dedication to therapy. Over the years, many treatments have been developed for the treatment of venous ulcers but most have little therapeutic value. The most effective way to heal a venous ulcer is a combination of the following therapies:

Leg elevation: Leg elevation is essential in the treatment of venous ulcer. When resting or lying down, elevate the legs. This will help reduce the swelling and decrease the pain in the legs.

Venous pressure: One must correct venous insufficiency: no matter what therapy is done, if the source of high venous pressure is not corrected, the ulcer will never be healed. If the cause is varicose veins, then the varicose veins must be treated and the high pressures eliminated.



Wound care: Wound debridement is important and frequent surgical clean will help stimulate growth of new skin. Wound debridement is required when the ulcer is foul smelling and contains dead tissue

Skin care: The skin must not be kept very wet or too dry

Antibiotics: If there is any evidence of a wound infection, antibiotics must be started.

Compression garments: This is probably the most effective therapy for a venous ulcer. The treatment is prolonged and requires a lot of determination and patience. The results are very slow, but eventually the ulcer will close if the high venous pressures are eliminated. The stockings are hard to get used to and may even be uncomfortable at the ulcer site. When the ulcer seeps fluid, the stockings may get dirty and need daily changing.

Washing: There are 100s of solutions recommended for the treatment of venous ulcers. It makes absolutely no difference what one uses. The best solution is simple warm clean water and a dry dressing.



Occlusive dressings: There are many types of occlusive and non occlusive dressings. Some topical dressings have antibiotics impregnated in them. However, if the venous pressure is not controlled, all these dressings are not only useless but a waste of a lot of money.

Skin grafts: The venous ulcer is always ugly looking and many individuals want it treated surgically. Skin grafts can be applied but only after the venous pressure has been decreased. Skin grafts have a very high failure rate and one should generally let the ulcer heal on its own

Growth factors: Today most wound clinics offer topical therapy with numerous growth factors. These growth factors are effective in the treatment of venous ulcers but only after the venous hypertension has been corrected. Growth factor treatment is also expensive.

The most important factor for the treatment of venous ulcer is controlling the high pressures in the vein. This may be done surgically by treating the varicose vein or one can wear compression stockings.