How To Best Treat Venous Wounds?
There are different types of wounds. Wound classification is based on various factors like underlying disease, injurious agent, and morphology of wound etc (the use of etc in a blog designed for patients is slightly confusing because the reader won’t know what are other options after “etc.”). Venous wounds are a type of wound. They are caused by dysfunction of the venous system and they mostly occur on legs, especially near feet.
Venous wounds or ulcers are usually shallow. The most common cause behind these wounds is incompetency of valves of the venous system of leg or legs. This incompetency causes pooling of the blood in the legs. Other causes include deep venous thrombosis (DVT), obesity, smoking, lack of physical activity, and performing activities that require standing for long periods of time etc. Chronic pooling eventually leads to the formation of venous wounds or ulcers.
When the blood pools into veins in the legs, it starts leaking out in surrounding tissues. This damages the tissues and as veins are usually superficial, wound or ulcer formation occurs.
These wounds are most commonly noticed on the sides of the legs on the lower area, above the ankle, and below the calves. These wounds or ulcers are known for their slow healing and they can come back quickly if the underlying issue is not treated. This is why treating the underlying cause is necessary along with taking care of the wound.
The following are a few treatment options for venous wounds. Compression Therapy
Compression therapy is a standard care option and has been proven to be beneficial for venous wounds. It involves the application of pressure on the legs, which promotes the return of blood to the heart. It decreases edema, makes venous reflux minimum, fastens wound healing, and manages pain.
There are different ways to give compression therapy. These include elastic compression, inelastic compression, and intermittent pneumatic compression. Intermittent pneumatic compression therapy involves a pump which has the function to deliver air to an inflatable and
As blood pooling in the venous system of the legs is the major cause of these wounds, leg elevation is a technique which provides relief. It can be used in combination with compression therapy, or alone as a standard treatment option.
This technique involves raising the legs above heart level. It promotes blood flow toward the heart and subsequently relieves pooling. It is usually recommended for thirty minutes, three to four times a day, for visible results.
Dressing Of The Wound
While dressing has a major role in treating other wounds, it has not been proven to be any better than available treatment options for venous ulcers. However, it can be opted as per the preferences of the patient and the requirement of the wound. (this last sentence is probably not necessary)
There are various different dressings available that include compression bandages, hydrogel, foams, hydrocolloids, pastes, and non-adherent dressing etc.
There are various drugs that can help with the treatment of venous wounds. These drugs include aspirin, pentoxifylline, iloprost, antibiotics, and zinc therapy. These drugs have the different mechanism of actions.
A newer option is hyperbaric oxygen therapy. In this procedure, high-pressure oxygen is applied to wound. It has anti-bacterial and anti-inflammatory effects. However, this therapy is more beneficial for other kinds of wounds.
Surgical Treatment Options
The available surgical treatment options focus on treating the underlying cause and closure of the wound. These options include surgical debridement of the wound and skin grafting. Surgical debridement is of various types and it makes sure that wound is clean and free of any debris. Skin grafting closes the wound.
Other surgical treatments involve treating the insufficient valves using different techniques that eventually lead to wound healing.
Vacuum-assisted closure is a newer technique. It involves the closure of the wound mechanically by applying negative pressure topically using a vacuum device. This technique reduces the wound size and volume to a significant extent.
Muzammal Habib, MD
Vascular Medicine and vein specialist
Dr. Habib has been practicing vein care and vascular More about this author »