By Hy-Tape International
Chronic venous insufficiency disease and resulting venous leg ulcers are serious and common conditions, particularly among older adults. More than half of lower extremity ulcers are caused by venous insufficiency disease. In a diseased venous system, the patient’s venous pressure will not be reduced on ambulation. This sustained pressure can lead to venous ulcerations and other complications.1,2 This makes the management and treatment of the condition important for many health care professionals, especially those working in hospice or other long-term care facilities. By working to prevent ulcers before they start, choosing more effective medical adhesives and dressings, and following wound care best practices, health care professionals can help reduce wounds resulting from chronic venous insufficiency disease.1,2
Best Practices for Venous Leg Ulcer Treatment
Venous leg ulcer treatment and management require frequent examination of at-risk patients and best practice wound care with a focus on prevention. Without effective treatment, venous leg ulcers can become extremely painful and result in cellulitis, osteomyelitis, and even death.1 To prevent these complications, health care professionals must actively work to identify venous leg ulcers, manage exudate, and choose wound dressings that enable an optimal healing environment. This can help promote rapid healing, reduce costs, and improve quality of life for patients.1
Identifying At-Risk Patients – One of the most important components of venous leg ulcer management is prevention. Venous leg ulcers are caused by inflammatory processes that lead to endothelial damage, platelet aggregation, and intracellular edema. By taking steps to identify at-risk patients and regularly assessing them for signs of ulcers, health care professionals can reduce the incidence of the disease. Older adults, obese patients, those with mobility issues, and those who have previously had a venous leg ulcer are all significantly more likely to develop venous ulcers.1
Elevate Legs – Leg elevation for 30 minutes three to four times a day can help reduce edema and thus may positively affect inflammation.1
Use Compression Therapy – The application of pressure helps restore valve competence and reduces ambulatory venous pressure, by helping to reduce venous reflux. This treatment can heal most small venous ulcers and reduce pain and edema.3
Manage Exudate – A major challenge when managing venous leg ulcers is the production of exudate. This can be uncomfortable for patients, by producing unpleasant smells and necessitating frequent dressing changes. Exudate containing proteolytic enzymes may also slow the wound healing process and damage the wound bed.4 To reduce this issue, health care professionals should frequently clean exudate and choose a dressing that helps in the management of excess exudate.1
Dress the Wound – Dressings aid in the treatment of venous leg ulcers by protecting the wound, preventing adherence of compression bandages, and enabling an ideal healing environment.1,5
Choosing More Effective Dressings and Medical Adhesives
Wound dressings are key components of effective venous leg ulcer treatment. Using the right dressing and using a secure, gentle medical adhesive can help the patient be more comfortable, promote rapid healing, and reduce costs.1 Important considerations when choosing a dressing and medical adhesive for a venous leg ulcer include:
Wear Time – The wear time of a dressing can have a major impact on patient comfort and the cost of care. Dressings and medical adhesives that have a longer wear time and are water resistant will necessitate fewer changes, thereby reducing the impact on the patient’s life and minimizing time spent on wound management.
Gentleness – Wound dressings and adhesives that irritate the skin may exacerbate the venous leg ulcer and cause patient discomfort. It is important to identify any potential allergic reactions and choose dressings and medical adhesive products that are gentle on the skin.,1,5
Healing Environment – A moist wound environment is critical to rapid and complete healing. Hydrogels, films, and hydrocolloids can help promote this environment and protect the wound from contamination. Secure medical adhesives will also help ensure that the healing environment is maintained and no foreign material enters the wound area.5
Exudate Management – Dressings containing products that absorb or otherwise manage exudate may also be beneficial, by helping to control inflammation and promote rapid wound healing.6 Securement of the dressing is critical in preventing exudate leakage, which can have a damaging effect on healthy skin tissue surrounding the wound area.
With best practice wound management, it is possible to reduce the impact of venous leg ulcers, even in the most vulnerable populations. Secure wound dressings are essential in the management of exudate to support an optimal healing environment and contain exudate from moderately to heavily draining venous leg ulcers. Use of a strong, moisture-resistant medical tape plays a key role in the effective securement of wound dressings when managing venous leg ulcers. By choosing appropriate dressings based on the level of wound exudate, clinicians can support an optimal healing and can provide the best possible care while reducing costs and time spent changing dressings.
1. Collins LG, Seraj S. Diagnosis and treatment of venous ulcers. Am Fam Physician. 2010;81(8):989–96. www.aafp.org/afp/2010/0415/p989.html.
2. Capeheart J. Chronic venous insufficiency: a focus on prevention of venous ulceration. J Wound Ostomy Continence Nurs. 1996;23(4):227–34. doi:10.1016/s1071-5754(96)90096-0.
3. Nair B. Compression therapy for venous leg ulcers. Indian Dermatol Online J. 2014;5(3):378. doi:10.4103/2229-5178.137822.
4. Dowsett C. Management of wound exudate. Independent Nurse. February 6, 2012. Available at: www.independentnurse.co.uk/clinical-article/management-of-wound-exudate/.... Accessed April 22, 2018.
5. Rai R, Dogra S. Venous leg ulcer: topical treatment, dressings and surgical debridement. Indian Dermatol Online J. 2014;5(3):371. doi:10.4103/2229-5178.137820.
6. Lloyd-Jones M. Superabsorbent dressings: clinical and psychosocial benefits. Br J Nurs. 2012;5(21):8–21.
About the Company
Hy-Tape International has strived to provide caregivers and patients with the highest-quality, most reliable, and gentlest surgical tape on the market for more than seven decades. As a leader in latex-free, zinc oxide–based surgical adhesives, Hy-Tape offers tape rolls that are available in seven different widths, as well as pre-cut adhesive strips, adhesive patches, and single-use rolls, thus giving health care providers a wide range of options for securing dressings and devices. Free product samples are available at www.hytape.com or by calling 1-800-248-0201.
Industry Voices is brought to you by health care industry sponsors. All content is developed and paid for by the sponsoring company. Kestrel Health Information, Inc. is not involved in the creation of this content. The views and opinions expressed in this blog are solely those of the author and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.