Essential Insights On Treating Chronic Venous Stasis Ulcers
• 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.
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.
1. Bolton L, Bernato L, Dotson P, et. al. Development of a content validated venous ulcer guideline. Ostomy Wound Manage. 2012; 28(3):35–48.
2. Neglan P, Eklof B, Kulwicki A, et al. Prevention and treatment of venous ulcers in primary chronic venous insufficiency. J Vasc Surg. 2010; 52(5Supp):
3. Finlayson K, Edwards H, Courtney M. Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. J Adv Nurs. 2011; 67(10):2180 -2190.
4. Snyder RJ. Treatment of nonhealing ulcers with allografts. Clin Dermatol. 2005; 23(4):388–95.
5. Brem H, Kirsner RS, Falanga V. Protocol for the successful treatment of venous ulcers. Am J Surg. 2004; 188(1A Suppl):1–8.
6. Mustoe T. Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy. Am J Surg. 2004; 187(5A):65S–70S.
7. Moreo K. Understanding and overcoming the challenges of effective case management for patients with chronic wounds. Case Manager. 2005; 16(2):62–3, 67.
8. Kakko SK, Rivera MA, Matsagas MI, et. al. Validation of the new venous severity scoring system in varicose venin surgery. J Vasc Surg. 2003; 38(2):224-8.
9. Stanley AC, Lounsbury KM, Corrow K, et al. Pressure elevation slows the fibroblast response to wound healing. J Vasc Surg. 2005; 42(3):546–51.
10. Collins L, Samina S. Diagnosis and treatment of venous ulcers. Am Fam Physician. 2010; 81(8):989–996.
11. Velasco M. Diagnostic and Treatment of Leg Ulcers. Actas Dermosifiliogr. 2011; 102(10):780-790.
12. World Union of Wound Healing Societies (WUWHS). Principles of best practice: Compression in venous leg ulcers. A consensus document. MEP Ltd.,