Treatment of venous ulcers

Leg ulcers may be due to problems with the arteries supplying blood to the leg or other conditions, such as diabetes, which require different treatments. But for those due to problems with the veins (called venous ulcers), treatment with a special form of bandaging to improve the blood flow may be needed. Surgery to remove incompetent veins may also be an option.

As well, many advances are being realized in the treatment of these ulcers using super-oxidized water such as the Microcyn® technology.

Symptoms of Venous Leg Ulcers

The features of a leg ulcer include:

• Commonly found on the lower leg and ankle
• Sunken, asymmetrically shaped wound
• Edges of the ulcer are clearly defined from the surrounding skin
• Surrounding skin is intact, but inflamed
• Surrounding skin may be pigmented, hardened or calloused
• Yellowish-white exudate
• Pain, particularly while standing
• Varicose veins in the leg

The calf muscle and poor circulation

Risk factors

A number of different factors can increase a person's risk of chronic venous leg ulceration, including:

• Age - peripheral circulation becomes less efficient with old age.
• Varicose veins - the one-way valves that stop blood from traveling backwards in the vein stop working. The pooling of blood stretches and distorts the vein.
• Cigarette smoking - tobacco is known to constrict the vessels of the circulatory system.
• Arterial disease - vein problems are more likely if the person already has other associated diseases of the arteries.
• Certain disorders - including diabetes and arthritis.
• Pressure sores - bed-bound people are at risk of pressure sores, which are areas of damage to the skin caused by constant pressure or friction.
• Medication - some cardiovascular drugs can contribute to leg oedema and altered circulation.

Treatment options

Treatment for chronic venous leg ulceration includes:

• Cleaning the wound - using wet and dry dressings and ointments, or surgery to remove the dead tissue. Microcyn® sterilant and antiseptic has been highly successful as part of a comprehensive treatment program.

• Specialised dressings - a whole range of products are available to assist with the various stages of wound healing. Dressings are changed less often these days, because frequent dressing changes remove healthy cells as well as debris.

• Occlusive dressings - ulcers heal better when they are covered; dressings should be changed weekly.

• Compression treatment - to boost internal pressure, using either elasticised bandages or stockings. This is particularly effective if multiple layers are used.

• Medications - such as painkillers, and oral antibiotics if infection is present.

• Supplements - there is evidence to suggest that leg ulcers may heal faster with mineral and vitamin supplements, but only if the person suffers from a deficiency. Zinc, iron and vitamin C may be used.

• Skin grafts - a surgical procedure, where healthy skin is grafted onto the prepared wound site.

• Hyperbaric oxygen - this is now an accepted management option for ulcers that resist other methods of healing for example, diabetic ulcers.

Long term outlook

Unless the underlying conditions are addressed and treated, the person is at risk of developing subsequent ulcers. Options can include treatment for varicose veins, quitting cigarettes, improving the diet and taking regular exercise (such as 30 minutes of walking every day). The person should avoid hot baths, and sitting still for too long. Keeping the affected leg elevated above the level of the heart, whenever practical, can help.

Things to remember

• The most common cause is poor circulation.
• Treatment options include compression bandages, dressings, surgery and, most recently, the super-oxidized Microcyn® solution.

NOTE: Microcyn® does not have U.S. FDA clearance for claims other than to moisten, lubricate, cleanse and debride wounds.