title: [Prophylaxis of Recurrent Venous Leg Ulcer].
abstract: Venous leg ulcer (VLU) counts among the most common chronic wounds in Europe. Treatment is lengthy, cumbersome and costly, and there is a high rate of recurrence. This review shows the measures that should be offered to every patient with healed VLU to permanently prevent recurrence. To prevent VLU in case of varicose veins, the progression of chronic venous insufficiency (CVI) has to be stopped. There is convincing evidence that the effective treatment of varicose veins reduces the recurrence rate in patients with VLU. In patients with post-thrombotic syndrome (PTS), further thrombosis should be prevented through targeted prophylaxis of new thromboembolic events. The benefit of endovascular revascularization on the VLU recurrence rate in patients with post-thrombotic damage in the pelvic veins has not been proven in clinical studies. On the other hand, it has been clearly demonstrated in several studies that compression therapy is the basic procedure for the prevention of recurrent VLU in patients with varicose veins or PTS, regardless of whether other measures have been implemented or not. Good adherence in patients with compression therapy is more important than choosing the highest possible compression class. Future efforts for patients with VLU must aim to provide therapists with tools and treatment strategies to guide their patients and to increase patients' acceptance and understanding of the importance of self-management, in particular regarding compression therapy for the prevention of recurrent VLU.
authors: Angiologie, HELIOS Kliniken Krefeld, Deutschland.
authors: K
authors: K
authors: Kroeger
authors: Gefäßzentrum Karlsruhe, Städt. Klinikum Karlsruhe, Deutschland.
authors: M
authors: M
authors: Storck
authors: Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland.
authors: P
authors: P
authors: Kujath
authors: Klinik für Dermatologie, Universitätsklinik Bonn, Deutschland.
authors: E
authors: E
authors: Rabe
authors: Klinik für Dermatologie, Universitätsklinik Essen, Deutschland.
authors: J
authors: J
authors: Dissemond
mesh_terms: D010349:Patient Compliance; D010353:Patient Education as Topic; D055502:Secondary Prevention; D012648:Self Care; D053828:Stockings, Compression; D014647:Varicose Ulcer / Q000517:prevention & control*; D014648:Varicose Veins / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014689:Venous Insufficiency / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014945:Wound Healing / Q000502:physiology