Care of venous leg ulcers

For many decades, few advances occurred in the treatment of venous ulcers. Clinicians mainly relied on compression using gauze impregnated with zinc oxide--the Unna boot. During the past few years, however, much has changed in favor of clinicians. A variety of compression bandages are now available along with effective wound dressings that take advantage of moist wound healing, better topical agents, new systemic therapies, and living bioengineered skin. In fact, the problem facing clinicians today may be in deciding what treatments to use in addition to compression therapy, which remains the accepted standard of care for venous ulcers. This paper discusses advances that have occurred during the past several years in the understanding and treatment of venous leg ulcers, and their implications for clinical practice, education, and future research.