Venous leg ulcer (ulcus cruris venosum)
When wounds won't heal
How a venous leg ulcer develops
Preconditions for wound therapy
Efficient treatment of venous leg ulcers comprises:
- Cleaning of the wound and care of the surrounding skin.
- Compression treatment is an element of wound care, even if many people believe that wound care is restricted to cleaning and wound dressings.
- Treatment of the underlying disease, which means that the venous disease has to be treated. Medical compression stockings and inelastic compression wraps are used as disease-modifying treatment. The pressure should improve the blood circulation in your leg, boosting your body’s ability to heal the sore.
- Solutions to effectively prevent recurrence
Phases of treatment and healing
Phase 1: wound debridement
As a result of the chronic insufficiency of the leg veins, venous leg ulcers are usually surrounded by hardened connective tissue that must be removed. Dressings with silver particles are used to disinfect inflamed wounds that are infected by bacteria.
Phase 2: formation of new connective tissues
During the second phase of wound healing, the body refills the gap in the skin. In order to promote the growth of the connective tissue, flat dressings (hydrocolloid and hydropolymer dressings) are applied that stimulate the production of connective tissue and keep the wound moist.
Phase 3: growth of new skin
During the third phase of wound healing, the wound contracts and skin cells grow inward from the wound margin to close the wound. Since phases 1 and 2 of wound healing are severely impaired in chronic insufficiency of the leg veins, most venous leg ulcers do not reach the third phase without supportive wound treatment. In this last phase, too, the wound must have a balanced level of moisture and the dressing must not be allowed to adhere to the tender, young skin. Thin, flat dressings (hydrocolloid or hydropolymer dressings) are usually used for this purpose.