Medical and Surgical Treatment of Chronic Venous Ulcers

Abstract Venous ulcer of the lower extremity is common vascular condition and 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 may improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents may promote more rapid healing, particularly in patients with longstanding ulcers. Current vascular surgical practice is to eliminate documented reflux or obstruction in patients with chronic venous ulceration 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 may decrease the time-to-healing of CVUs compared with compression therapy alone, but does not increase the proportion of ulcers healed.