Simplifying venous leg ulcer management

Many countries have published guidelines, which state that compression therapy is the 'gold standard' treatment for venous leg ulcers 1–11. Compression therapy is known to significantly increase VLU healing rates and reduce the risk of recurrence 12–13.

Despite this, efforts to heal VLUs are often focused on the use of advanced wound dressings and other therapies, while an established key to healing — compression therapy — is underused.
An international group of experts in leg ulcers and venous disease met in December 2014.

The group recognised that a very high proportion of all leg ulcers have venous disease as a causative or contributory factor (i.e. are VLUs or mixed aetiology ulcers) and so may be appropriate for compression therapy. Their discussions centred on identifying how to encourage wider adoption of compression therapy by simplifying the key principles involved.

The conclusions reached form the basis of this document and are presented as an ABC of the management of VLUs, with the focus on the active treatment phase. It is hoped that this simplified approach will help clinicians to clearly understand why, when and how compression therapy should be used. Everyone involved in wound healing should be ambitious in striving for a step change that decisively overturns passivity in expecting lengthy, delayed or non-healing of VLUs and other leg ulcers associated with venous disease. We need to actively seek to enhance affected patients' lives by improving healing rates through increased appropriate use of compression therapy.

Keith Harding et al.
Medical Director, Welsh Wound Innovation Centre, and Dean of Clinical Innovation, Cardiff

Citation reference

Harding K, et al. Simplifying venous leg ulcer management. Consensus recommendations. Wounds International 2015.