Improving Venous Ulcer Outcomes

Abstract

Venous leg ulcers (VLUs) are caused by compromised flow of venous and lymphatic fluids from the lower leg toward the central circulatory system. They are one of the most common types of chronic wounds, affecting 3% to 5% of those 65 years of age and older.1 Most VLUs heal within 12 weeks with sustained lower leg compression sufficient to reduce the edema associated with venous insufficiency.2 Diagnosing and improving a patient’s venous insufficiency and addressing concomitant arterial disease are key elements of VLU management.3 Surgical correction has been effective for superficial venous insufficiency.4 Various topical,5 physical,6 or systemic7 interventions have been studied as adjuncts to compression in efforts to further improve VLU outcomes, with mixed results. This month’s Evidence Corner summarizes recent randomized clinical trials (RCTs) documenting healing effects of topical gauze dressings impregnated with hyaluronic acid (HA) or placebo cream8 as an adjunct to patient-appropriate compression or low-level laser radiation as an adjunct to clinically prescribed elastic compression, diet, leg elevation, exercise, and moisture-retentive, absorbent, or microbicidal dressings.9