Modalities to Treat Venous Ulcers: Compression, Surgery, and Bioengineered Tissue

Area of Science:

• Vascular Surgery
• Wound Care
• Regenerative Medicine

Background:

• Venous leg ulcers (VLUs) are the most common lower extremity ulcers, characterized by slow healing and high recurrence rates.
• Comorbidities in VLU patients often impede wound healing, necessitating a multidisciplinary care strategy.
• Effective VLU management requires addressing venous anatomy and its inflammatory effects on the wound environment.

Purpose of the Study:

• To review current literature on venous leg ulcer treatment, focusing on compression, surgical interventions, and bioengineered tissues.
• To develop a summary and algorithm for an integrated approach to VLU management.
• To provide clinicians with information on compression modalities and diagnostic imaging for VLU treatment.

Main Methods:

• Systematic review of society guidelines, Cochrane reviews, and over 80 primary articles.
• Synthesis of evidence-based modalities for VLU treatment.
• Development of a treatment algorithm for integrated VLU and venous disease management.

Main Results:

• A comprehensive approach to chronic venous insufficiency (CVI) involves advances in compression therapy, diagnostics, and minimally invasive venous surgery.
• Integration of wound bed preparation and bioengineered skin substitutes enhances healing.
• The presented algorithm facilitates early ulcer and venous disease treatment, promoting healing and recurrence prevention.

Conclusions:

• Evidence-based guidelines and modalities optimize outcomes and resource utilization in VLU care.
• A proactive strategy for managing venous disease alleviates patient suffering and prevents long-term complications of CVI.