What Is the Best Treatment For Leg Ulcer?
The typical treatment for a leg ulcer is a compression bandage or stockings.
The reason for this is that the bandage doesn’t put additional pressure on the ulcer while the patient is at rest.
Some doctors may recommend that the patient sleep in a compression bandage, but that’s not always recommended.
In addition to compression bandages, a doctor may also recommend surgery. Listed below are some treatments for a leg ulcer.
Compression therapy
The use of compression therapy is a proven anti-inflammatory and antihypertensive treatment for leg ulcers.
There are few absolute contraindications to compression therapy.
However, patients with severe peripheral artery disease, cardiac insufficiency, or a true allergic reaction to compression materials should not use this treatment.
Compression therapy has multiple salutary effects, including reducing swelling and pain, improving tissue remodeling, and increasing arterial flow.
The most common contraindication to compression therapy is the presence of polyneuropathy.
This condition causes patients to lose their ability to feel pressure and pain.
They may not feel excessive compression or too-tight stockings, or inadequate padding.
Compression therapy should be applied only after the patient has reached the decongestive phase when their condition is stable and their symptoms have resolved.
Before starting this treatment, clinicians should carefully examine the affected leg, looking for signs of pressure marks and skin lesions.
It is also important to take measurements of the calf and ankle to document the decongestion phase.
Debridement
Several debridement techniques have been identified as the most effective treatment of leg ulcer
s. Although there are numerous benefits of debridement, the evidence base for these methods is limited.
The primary benefit of debridement is to create a clean wound bed. However, there are some drawbacks to debridement.
In addition to being costly, this method is not as easy to perform as it sounds, and many patients may have no other option but to undergo the surgery.
The primary disadvantage of debridement is pain. In addition to pain, debridement can also result in infection and pain.
During the healing process, the wound will still contain some dead tissue. If this remains, it can harbor bacteria, which can result in more serious complications.
In these cases, the dead tissue should be removed.
This promotes healing and reduces the risk of infection. However, some patients may experience some pain after the procedure, which can be uncomfortable or even painful.
Elevation
Currently, the best treatment for leg ulcers is to elevate the affected leg. This can be done three to four times a day and can reduce the chances of recurrence.
It is important to remember that elevation is only one part of the treatment for leg ulcers.
It is important to raise the affected leg to a comfortable level and do so slowly and carefully.
After a week of elevating the affected leg, the wound will be much smaller. In addition to elevating the leg, it is important to keep the affected area elevated as much as possible.
This is especially important for ulcers on the bottom of the foot, which must be “off-loaded” for optimal healing.
Special footgear and specialized castings can help reduce pressure on the affected area.
The patient may also use crutches or wheelchairs to help relieve the pressure. This can help the leg heal faster.
Surgery
The diagnosis of leg ulcers is largely clinical, although further investigations may be necessary in certain cases.
The surgical procedure is chosen based on the patient’s etiology and the proposed course of treatment.
The goal of surgery is to decrease the increase in venous pressure while increasing the arterial perfusion pressure.
This requires a precise diagnosis and is recommended for ulcers caused by venous insufficiency.
The study included 412 patients with active leg ulcers and two groups of treatment.
In one group, all patients received standardized ambulatory compression therapy and in the other, half received SEPS and superficial venous incompetence.
The allocation to treatment groups was done using a computer-generated randomization center.
The primary endpoint was ulcer-free interval at follow-up. Secondary endpoints included healing and recurrence rates.
Conclusion
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