Abstract
The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.
Highlights
Chronic venous insufficiency (CVI) is a disease with numerous symptoms, including skin changes resulting from circulation disturbances caused by venous valve failure, venous reflux, an insufficient venous return, post-thrombotic syndrome, and venous hypertension [1,2,3,4,5]
Chronic venous insufficiency (CVI) in legs is a disease as a result of venous circulation disturbances; Venous leg ulcer (VLU) is the most advanced form of CVI; About 75% of leg ulcers have venous etiology which is the most common cause of chronic leg wounds; The risk factors for VLU include advanced age, deep venous thrombosis, female gender, phlebitis or obesity; Standard of care in VLU treatment consist of local wound management and compressive therapy; Despite appropriate treatment, the average time for venous leg ulcers (VLUs) healing varies from 6 to 12 months; VLUs can be resistant to treatment; 20% of VLUs cases do not cure within 24 months; In the case of VLUs standard treatment failure, advanced therapy should be considered
It is considered that electro-active biomaterials or wearable, self-sustainable Electrical stimulation (ES) can act as wound care management in the future [22]
Summary
Chronic venous insufficiency (CVI) is a disease with numerous symptoms, including skin changes resulting from circulation disturbances caused by venous valve failure, venous reflux, an insufficient venous return, post-thrombotic syndrome, and venous hypertension [1,2,3,4,5]. Standard care in VLU treatment consists of local wound management and compressive therapy [9,10]. Other therapeutic methods can be applied, including skin transplants, in order to achieve wound closure [18]. If standard treatment fails, advanced therapy methods should be taken into consideration that can be applied as adjuvants to conventional treatment [19,20] Another challenge in VLU treatment is frequent recurrence. New therapies for chronic venous ulcers are still expected and the number of new wound management techniques increased in the last years and are sequentially being refined [1,12]
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