Treatment outcomes in the management of lower extremity venous stasis ulcers

Abstract

The aim of the study is to present the treatment outcomes in patients with venous stasis ulcer and summarize results with a brief review of the literature. Thirty patients with venous leg ulcers referred to a single chronic wound care unit with a minimum one year follow-up were included. Demographic features, co-morbidities, localization and characteristics of the ulcerated lesions, symptoms, arterial and venous Doppler ultrasound examination results, wound culture results, and outcomes of medical and surgical treatments were summarized. The treatment approach includes treating superficial and deep infections, obtaining tissue revascularization, compression, daily wound care, oral pentoxifylline, reconstruction of the major skin defects with split thickness skin grafts and hyperbaric oxygen therapy in refractory lesions. Mean age was 54 (32-85). Male to female ratio was 87%. Most common symptom was edema (83%). Mean size of ulcers were 20 cm² (4-45). Seven patients were hospitalized. Eighty % of patients had venous insufficiency. Most common isolated pathogen was P. aeruginosa (23%). Most common complication was osteomyelitis (5%). Hyperbaric oxygen therapy was applied to 3 patients. Split thickness grafts were used for the treatment of the skin defects in six (%20) patients. There was no recurrence of lesion in any patients at one year follow-up. Despite chronic lower extremity venous stasis ulcers are difficult to treat and related with a high risk of recurrence, it is possible to obtain good results with patient education and a systematic treatment approach.