No More Venous Ulcers—What More Can We Do?

Abstract

Venous leg ulcers (VLUs) are the most severe complication caused by the progression of chronic venous insufficiency. They account for approximately 70–90% of all chronic leg ulcers (CLUs). A total of 1% of the Western population will suffer at some time in their lives from a VLU. Furthermore, most CLUs are VLUs, defined as chronic leg wounds that show no tendency to heal after three months of appropriate treatment or are still not fully healed at 12 months. The essential feature of VLUs is their recurrence. VLUs also significantly impact quality of life and could cause social isolation and depression. They also have a significant avoidable economic burden. It is estimated that the treatment of venous ulceration accounts for around 3% of the total expenditure on healthcare. A VLU-free world is a highly desirable aim but could be challenging to achieve with the current knowledge of the pathophysiology and diagnostic and therapeutical protocols. To decrease the incidence of VLUs, the long-term goal must be to identify high-risk patients at an early stage of chronic venous disease and initiate appropriate preventive measures. This review discusses the epidemiology, socioeconomic burden, pathophysiology, diagnosis, modes of conservative and invasive treatment, and prevention of VLUs.

Clinical and microbiological features of host-bacterial interplay in chronic venous ulcers versus other types of chronic skin ulcers

“…A higher proportion of severe septicemic events resulting in death were observed in patients diagnosed with other types of chronic skin lesions (Group 2) compared to patients with venous ulcers (Group 1; Weller et al, 2021;Stanek et al, 2023).…”

“…Most chronic wounds of the lower limbs are of venous etiology (70%–90%; Kahle et al, 2011 ; Stanek et al, 2023 ). Chronic venous ulcers of the lower limbs are defined as wounds that develop in the context of advanced venous disease, with a slow healing rate and no tendency to heal over 3 months despite adequate treatment or not fully healed at 12 months ( Kahle et al, 2011 ; Stanek et al, 2023 ).…”

“…Most chronic wounds of the lower limbs are of venous etiology (70%–90%; Kahle et al, 2011 ; Stanek et al, 2023 ). Chronic venous ulcers of the lower limbs are defined as wounds that develop in the context of advanced venous disease, with a slow healing rate and no tendency to heal over 3 months despite adequate treatment or not fully healed at 12 months ( Kahle et al, 2011 ; Stanek et al, 2023 ). They have a significant impact on the patient’s quality of life, being associated with depression and worrisome suicide rates, as well as an economic burden due to increased medical care costs (dressings, hospitalization, and others; Kahle et al, 2011 ; Weller et al, 2021 ; Stanek et al, 2023 ).…”

Kick-Starting Wound Healing: A Review of Pro-Healing Drugs

“…Wound dressings incorporating novel biomaterials [24], altering fluid balance [25] and modifying the pH of the wound environment [26][27][28] have greatly improved outcomes for chronic wound patients. Importantly, chronic wounds are often a result of underlying pathology, and advances in the treatment of diabetes [29,30] and venous insufficiency [31] are some of the best ways to reduce the burden of chronic wounds. Here, we examine the progress made in developing therapeutics designed to improve the healing of chronic wounds and their proposed mechanisms of action (Figure 2).…”

Quality of Life in Patients with Venous Leg Ulcers Treated by Means of Local Hyperbaric Oxygen Therapy or Local Ozone Therapy—A Single Center Study

“…Ulcers are primarily the cause of chronic pain and limited mobility, which significantly reduces the sense of the quality of life of treated patients. The burdensome, painful nature of the disease, its chronicity, and frequent relapses force patients to actively seek help [8,9].…”