Chronic Venous Insufficiency: Therapy

General measures

  • Little sitting and standing
  • A lot of walking or moving (= activation of the muscle pump).
  • Elevating the legs for 30 minutes 4-5 times a day; this significantly reduces the tendency to edema (water retention) and improves microcirculation.
  • Cold showering of the legs should be done regularly
  • Foot exercise movements help to avoid limiting the mobility of the ankle joint
  • Heat such as sauna, sunbathing leads to vein dilation and should therefore be avoided!
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.

Measures in venous leg ulcers

  • Cleansing of the ulcer (ulcer):
    • An advantage of moist wound treatment is documented
    • You can use different forms of wound dressings
    • During dressing changes (VW) should be used if necessary drinking water or physiological saline solution for cleaning
    • The edge of the ulcer can be protected from maceration (softening of the tissue) with zinc paste
  • Compression bandage (Evidence level: 1a/A) – best with short zugelastischen materials, compression stocking.
  • In the case of a florid ulcus cruris venosum (disease that is in the stage of full symptom expression), the tetanus vaccination protection should also always be checked (see below).

Drug therapy

  • Antiseptics (agents to prevent wound infection).
  • Flavonoids* (γ-benzopyrones)
  • Heparins*
  • Horse chestnut extracts* (saponosides)

* Data for the benefit of these active substances is partly contradictory!

Surgical therapy

  • May be required if the cause of chronic venous insufficiency is varicosis (varicose veins)

Vaccinations

In the case of a florid venous leg ulcer, tetanus vaccination protection should also always be checked

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a healthy mixed diet taking into account the age. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Light endurance training (cardio training).
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Physical therapy (including physiotherapy)