Essential Insights On Treating Chronic Venous Stasis Ulcers

Start Page: 70
Nanjin J. Park, DPM, Latricia Allen, DPM, MPH, Guosheng Gu, MD, and Vickie R. Driver, DPM, MS, FACFAS

   Patients need to understand the treatment plan, the goals of treatment and how the patient and clinician are going to work together to achieve the stated goals. One needs to establish and maintain trust if the treatment is to be effective. It is important patients understand that venous leg ulcers often recur and that treatment is an ongoing process of preventing future ulcers and managing acute ulcerations.

   As healthcare providers, it is important to teach patients to monitor their wounds, check for complications often and maintain a daily self-care regimen. This regimen should include the following points.

• Wash feet daily and check for sores, calluses, blisters, injury or infection. Notify your doctor of any such condition.
• Keep the wound and dressing clean and dry, changing the dressing as directed.
• Wear comfortable shoes that do not restrict circulation.
• Maintain regular physical activity. This should include an exercise program advised by a physician or physical therapist. Low-impact exercise, such as walking 30 minutes per day and/or stretching, would be helpful.
• Stop smoking.
• Eat a well-balanced, heart healthy (low salt, low fat) diet. Following such a diet can reduce blood pressure, blood cholesterol and blood sugar levels.
• Maintain a healthy weight.
• Use compression socks if appropriate.
• Elevate legs one hour daily

   Lastly, it is important to communicate with different specialties for input and advice on the treatment plan. This will reduce the long-term cost and will produce a more effective result for the patient.

In Conclusion

Regardless of the etiology of venous ulcerations, it is fundamentally necessary to develop a protocol for clinical practice. One must adapt any preventive method to the patient’s socioeconomic needs and abilities if it is to be effective. Clinicians need to balance the patient’s needs and desires as they pertain to quality of life issues and associated economic resources. Ultimately, the success or failure of treatment will rely on the trust and teamwork that develops between patients and providers.

   Dr. Park is a Research Fellow in Limb Preservation and Wound Healing in the Department of Surgery at the Boston University School of Medicine and Boston Medical Center.

   Dr. Allen is the Chief Podiatry Surgical Resident at the Atlanta Veterans Affairs Medical Center in Decatur, Ga.

   Dr. Gu is an International Scholar in Limb Preservation and Wound Healing in the Department of Surgery at the Boston University School of Medicine and Boston Medical Center. He is also a General Surgeon at the Jinling Hospital at the Nanjing University School of Medicine in Nanjing, China.

   Dr. Driver is an Associate Professor of Surgery and the Director of Clinical Research, Limb Preservation and Wound Healing at the Boston University Medical Campus and the Boston University School of Medicine. She is also the Director of the Research Fellowship and International Scholars Program at those institutions.


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