Venous Leg Ulcer: Therapy

General measures

  • Exercise.

Local wound therapy

  • One benefit of moist wound treatment is documented
  • One can use different forms of wound dressings.
  • When changing dressings (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
  • Application of
    • Polarized, polychromatic, non-coherent light.
    • Pulsed electromagnetic fields, pulsed direct current.
  • Application of ultrasound
  • Topical negative pressure treatment

Conventional non-surgical therapy methods

  • Medical compression therapy (to improve venous return from the legs; level of evidence: 1a/A). – best with short-stretch materials, compression stocking (note: not for arterial circulatory disorders) [usually class II; optimal pressures are between 30 and 50 mmHg]; for more see “Compression therapy” below.
  • Radiological interventional therapy (level of evidence: 1b/A) – may be indicated to improve venous return.

Surgical therapy

  • Sclerotherapy (evidence level: 1b/A) – for obliteration of varices (varicose veins).

Vaccinations

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

Regular check-ups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. 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 fruits).
    • 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 grains, vegetables).
  • 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) and endurance training.
  • Athletic exercises (light endurance– strength and gymnastics training; three times a week) can significantly accelerate the healing process in venous ulcers. On average, the healing process took only 13 weeks to heal the lesions compared with 34.7 weeks in the control group.
  • Venous leg ulcers heal better with a combination of compression therapy and aerobic exercise: the best result was obtained with strength plus endurance training (three times per week; walking (10,000 steps per day) or exercising on a treadmill or bicycle ergometer):
    • Compression plus training: ulcer healing within twelve weeks: 60.6% of patients (57 of 94).
    • Compression alone: 45.8% (44 of 96).

    CONCLUSION: With additional training, 14% (14 of 100) more achieved ulcer healing.

  • Preparation of a fitness or training plan with appropriate 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)