Venous Ulcers

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Article Title: A Randomized Trial of Early Endovenous Ablation in Venous Ulceration
Authors: Gohel, Manjit; Heatly, Francine; Liu, Xinxue; Bradbury, Andrew; Bulbulia, Richard; Cullum, Nicky; Epstein, David; Nyamekye, Isaac; Poskitt, Keith; Renton, Sophie; Warwick, Jane; Davies, Alun
Journal: N Engl J Med
Reviewed by: Kyle Miller, Class of 2020, Temple University School of Podiatric Medicine

by the WoundSource Editors

Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year. Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as intrinsic and extrinsic factors, comorbidities, and mixed etiologies—may complicate this process.

by Karen Bauer , NP-C, CWS

In my recent WoundSource webinar on management strategies of venous leg ulcers (VLU), I discussed the complex pathophysiology of VLUs and procedural interventions that can help them reach closure.

by the WoundSource Editors

In approaching the management of a chronic wound, the first step in developing a treatment plan that will combat chronicity and promote healthy healing of damaged tissue begins with understanding the different types of wounds.

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

With the millions of people living with chronic wounds, there are also millions of people living with cardiovascular disease. Every year, there are approximately 670,000 Americans diagnosed with heart disease. This equals more than one person diagnosed each minute! The skin may be the largest organ, but the heart is most vital in circulating oxygen and nutrient-rich blood throughout your body. A healthy heart is a leading factor in wound healing. Cardiovascular diseases that impede healing include peripheral arterial disease, coronary artery diseases, heart failure, and other heart and vessel issues that can inhibit blood, oxygen, and nutrition in wound healing.

by the WoundSource Editors

Venous leg ulcers can be painful, cause distress, and affect quality of life, from the weekly wound center visits, multilayer wraps, debridements, compression hose, elevation of legs above the heart, to the odor from heavy exudate.

by the WoundSource Editors

Chronic non-healing venous ulcer wounds are an economic burden to the health care system and are the most common type of leg ulcer, affecting around 1% of the population, with 3% of people aged over 80. With obesity and diabetes on the rise, the burden is likely to continue to increase. Lowered quality of life, amputation, and death are often the results of venous leg ulcer chronicity, and the rate of recurrence within three months after wound closure has been reported to be as high as 70%.

by the WoundSource Editors

Venous leg ulcers (VLUs) are difficult to treat, and when they are present a variety of complications may arise. These complications can be challenging to treat and may often contribute to the prolonged healing times resulting from chronicity found with many VLUs. Further, if the condition of the ulcer deteriorates, it may worsen any complication already present or serve as the catalyst for the development of complications.

by the WoundSource Editors

A venous leg ulcer (VLU) is caused by vein disease that primarily affects older adults. As a prevalent problem among older patients, providing care for individuals with VLUs is time-consuming and costly. The direct costs vary from country to country, with reporting numbers of €800 monthly in Germany. Statistics report $2,500 monthly in the United States per patient, and given the chronic nature of VLUs, the cumulative costs per patient increase rapidly.

by the WoundSource Editors

Enzymatic debridement: The use of a prescribed topical agent that can chemically liquefy necrotic tissue with enzymes. It is often less painful but can be more expensive than other forms of debridement.

Gaiter area: The area on the leg that extends from just above the ankle to below the knee.

Hypertension: Abnormally high blood pressure. Venous hypertension describes the existence of high pressure in the veins of the legs.