Unna boot central gauze technique for chronic venous leg ulcers

Abstract

Venous leg ulcers generally take manyweeks to heal. Novel therapies that shorten healingtime and require less complex care are needed. The purpose of this report is to presenta pilot study for a new method that can result ina faster healing time for venous leg ulcers usinginexpensive materials. A central-gauzeprotocol was developed as described here. A three-ply gauze sponge was placed in the center of theulcer, allowing a peripheral 3-5 mm rim of ulcer toremain exposed. Saline solution was applied to thegauze sponge. A 3-layer Unna boot was applied overthe ulcer with short-stretch compression. This noveltechnique exposed only a peripheral rim of the ulcerto the zinc oxide paste, allowing the central portionof the ulcer to drain through the saline-soaked gauze.The ulcer was photographed at each clinic visit andthe wound area was estimated by finding the bestfitellipse for the ulcer area and computing the areaof the ellipse by a standard formula. Threepatients with small venous leg ulcers treated with thezinc rim technique showed an average healing rate of46.1% per week (range 27.8% - 50.7%). All ulcers werenearly healed by three weeks. After the ulcer size wasreduced sufficiently, patients were discharged withinstructions to apply pieces of Unna dressing to theulcer, under a conventional self-adhesive bandage,maintaining compression, without any saline-gauzein the center. The three patients in thispilot study showed rapid healing for venous leg ulcerswith the central gauze modification of Unna boottherapy.