Types of Chronic Wounds  Venous Ulcers
Venous ulcers are most commonly found in the area above the ankle but can include any area below the knee. The leg may become swollen, causing the skin surrounding the ulcer to become dry, itchy, and sometimes brownish in color. Dermatitis (eczema) may occur.
Venous ulcers are caused by venous reflux. Venous reflux means that the blood flows backward through the circulatory system. When the veins are not working properly, the blood backs up into the superficial veins, increasing pressure and causing the veins to become elongated and dilated. The tissue surrounding those veins no longer receives a good supply of fresh blood, including the infection-fighting white blood cells. As a result, toxins remain in the tissue and the site may become ulcerated.
Testing & Treatment
Topical treatments may decrease the rate of infection and promote a moist environment, which stimulates healing. The creams and dressings may be used jointly with compression therapy—for example, Profore®—which applies pressure on the skin, causing the blood to flow correctly through the superficial veins to the deep veins. Well-conducted studies have shown that this combination of topical and compression therapies promotes the healing of venous ulcers.
If you are not healing with compression therapy, you will receive Apligraf®, which is a human cellular therapy. It is the only product approved by the FDA (Food and Drug Administration) in randomized clinical trials to accelerate wound closure.
After you heal, it is critically important to wear a compression stocking to help prevent recurrence.
Oral and IV antibiotics are specifically chosen based on the patient's medical condition and the type of bacteria growing in and around the wound. (Bacteria are identified through deep cultures or tissue samples.) To prevent the bacteria from becoming resistant, antibiotics are used selectively for finite periods of time.
Used correctly, antibiotics can promote a clean wound bed that will stimulate wound healing. If an infection is present, oral antibiotics are initially given. If cellulitis (redness) or other signs of infection have not improved after a week of oral antibiotics, intravenous (IV) antibiotics will be administered.
Vacuum-Controlled Assisted Closure (VAC) Therapy uses negative pressure to heal wounds. VAC has a special sponge that is placed in the wound bed and covered. A vacuum, which is connected to the sponge, extracts the drainage from the wound site and applies negative pressure to the site.
Debridement is a surgical procedure used to accomplish three goals:
- Stimulate wound healing
- Remove non-living tissue
- Remove infected tissue
Once non-living and infected tissue has been removed, the wound is stimulated to contract and heal.
To learn more about debridement, please click here.
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