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Venous Stasis Ulcers: an Update on Diagnosis and Management

  • Dermatology and Wound Care (C Sayed, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Venous leg ulceration (VLU) is a medically, financially, and psychologically debilitating disease for patients and a financial burden for the health care system. Of all dermatologic diseases, VLU generates the highest cost. The purpose of this manuscript is to review the current guidelines on the diagnosis and management of VLU with an emphasis on novel approaches.

Recent Findings

Two novel approaches to VLU diagnosis have been proposed in 2019 including voltammetric analysis to determine leg ulcer etiology, identify infection, and predict clinical course, and the use of dynamic optical coherence tomography to image blood capillaries of the peri-wound skin. Novel approaches to management include the use of trichloroacetic acid and low-frequency ultrasound debridement, growth factors harvested from human amniotic membrane or platelet-rich plasma, low-level laser therapy, and low-energy light therapy.

Summary

With shifting demographics toward an aging population, sedentary lifestyles, an increased prevalence of obesity, and the emergence of chronic diseases, VLU will likely continue to be a significant burden to patients and the health care system. Treatment should not purely be focused on healing, but should take a holistic approach, incorporating nutrition and well-being. The gold standard for the prevention and treatment of VLU is compression therapy and should be utilized with the TIME strategy which contributes to the stimulation of natural healing mechanisms and includes the following: Tissue debridement, Infection and inflammation control, Moisture balance, and Epidermization stimulation.

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Acknowledgments

We would like to thank the Dermatology Department at Albert Einstein/Montefiore for providing original images.

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  1. CUNY School of Medicine, 160 Convent Ave, New York, NY, 10031, USA

    Amaris N. Geisler

  2. Department of Dermatology, NYU Langone Hospitals, New York, NY, USA

    Nicholas Taylor

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Geisler, A.N., Taylor, N. Venous Stasis Ulcers: an Update on Diagnosis and Management. Curr Geri Rep 9, 219–228 (2020). https://doi.org/10.1007/s13670-020-00344-4

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