Practice patterns of adjunctive therapy for venous leg ulcers

Area of Science:

• Vascular Medicine
• Dermatology
• Wound Care

Background:

• Venous leg ulcers (VLUs) are severe outcomes of venous reflux and post-thrombotic syndrome.
• Effective VLU healing relies on addressing venous obstruction and reflux.
• Current adjunctive therapy practices for VLUs show significant variability.

Purpose of the Study:

• To assess current practice patterns for adjunctive therapies in venous leg ulcer (VLU) treatment among American Venous Forum members.
• To identify physician specialties, treatment settings, and reimbursement sources for VLU care.

Main Methods:

• An online survey was distributed to 667 American Venous Forum members.
• The survey comprised 16 questions on physician specialty, treatment location, practices, and reimbursement for VLUs.
• A response rate of 18.6% was achieved, with participants from diverse specialties and countries.

Main Results:

• Most respondents (49.5%) were vascular specialists; others included podiatrists, dermatologists, and primary care physicians.
• Compression therapy is universally used as the primary VLU treatment.
• Multilayer compression was the most common adjunctive therapy (58.8%), with over 90% initiating other modalities if VLUs failed compression, often within three months.

Conclusions:

• Venous leg ulcers are managed by a multidisciplinary team of physicians.
• Significant variation exists in the choice and timing of adjunctive therapies for VLUs.
• There is a critical need for evidence-based guidelines to standardize VLU treatment across specialties.