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
Generally, veins carry deoxygenated blood from the
body to the heart, where it can be sent to the lungs.
Veins have one-way valves to prevent blood from running
backwards. The contraction of muscles helps to massage
blood along the veins. The calf acts as a pump, using
muscular contraction in combination with deep veins
and chambers to help counteract gravity and push
the blood back up through the veins. This pumping
action can be hindered by a variety of problems,
including blockages in the deep veins, venous insufficiency
or venous disease. It is not known how poor vein
circulation triggers a leg ulcer. One current theory
proposes that white blood cells are trapped inside
the narrowed capillaries, the smallest blood vessels
of the circulatory system. These immune system cells
then attack and destroy the nearby skin tissue. Evidence
for this theory includes high numbers of white blood
cells and their by-products found in the pus of leg
ulcers.
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. |
