Medical and surgical treatment of chronic venous ulcers.
Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with CVU that have failed a 3-month period of compression dressing, debridement, and local wound care. We found that surgical treatment of the superficial venous system can decrease the time to healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed.
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
Michol A
MA
Cooper
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
Umair
U
Qazi
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
Eric
E
Bass
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
Jonathan
J
Zenilman
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
Gerald
G
Lazarus
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224.
M Frances
MF
Valle
Johns Hopkins Medical Institutions, 4940 Eastern Avenue, Baltimore, MD 21224. Electronic address: mbmalas@jhmi.edu.
Mahmoud B
MB
Malas
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D058128:Compression Bandages; D006801:Humans; D012008:Recurrence; D015911:Sclerotherapy; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014945:Wound Healing
D000900:Anti-Bacterial Agents