Treatment
16
Compression
Compression–Ulcer Healing
➤ In a patient with a venous leg ulcer, we recommend compression
therapy over no compression therapy to increase venous leg ulcer
healing rate. (1-A)
Compression–Ulcer Recurrence
➤ In a patient with a healed venous leg ulcer, we suggest compression
therapy to decrease the risk of ulcer recurrence. (2-B)
Multicomponent Compression Bandage
➤ We suggest the use of multicomponent compression bandage over
single-component bandages for the treatment of venous leg ulcers.
(2-B)
Compression–Arterial Insufficiency
➤ In a patient with a venous leg ulcer and underlying arterial disease, we
do NOT suggest compression bandages or stockings if the ankle-brachial
index is 0.5 or less or if absolute ankle pressure is <60 mm Hg. (2-C)
Intermittent Pneumatic Compression
➤ We suggest use of intermittent pneumatic compression when other
compression options are not available, cannot be used, or have
failed to aid in venous leg ulcer healing after prolonged compression
therapy. (2-C)
Table 7. General Categories of Wound Therapy for VLUs
Wound bed preparation
Wound cleansers
Débridement
• Surgical débridement
• Anesthesia for débridement
• Hydrosurgical débridement
• Ultrasonic débridement
• Enzymatic débridement
• Biologic débridement
