Venous ulcers

VENOUS ULCERS

Venous ulcers are wounds that appear in the maximum stage of chronic venous insufficiency (clinical stage 6 of the CEAP classification), and that normally close between 30 and 70% of the lesions with standard treatment. This basic or standard treatment essentially includes three pillars:

Elastic compression or elastic bandage in different forms. The most widely used is the multilayer bandage combining different types of bandage. Local treatment that is carried out with different dressings, ointments or creams depending on the type of wound to be treated. Pharmacological treatment: one of the most used medications is pentoxifylline 400 mg 3 times per day, or the purified micronized flavonoid fraction 1 g per day in selected groups.

According to what is called EBM, evidence-based medicine, which is the combination of the best current scientific evidence combined with the experience of the doctor or the treating group, after implementing this basic treatment, the patient must be observed for a period of 4 weeks. If the wound improves, we must maintain the same ("4 week plan" according to publications in the US and the world), otherwise reassessment is always indicated to confirm the diagnosis, since venous ulcers are the most frequent wounds in the lower limbs, but there are many other causes that we must rule out. If this basic treatment does not work, which happens in 1 or 2 out of 10 patients treated in our hands, we should think about installing what is called advanced or complementary treatment, to consider other treatments such as platelet-rich plasma, smart dressings , grafts, topical negative pressure therapy and others.