Treatment
14
Topical Antibiotics for Infected Wounds
➤ We suggest against use of topical antimicrobial agents for the
treatment of infected venous leg ulcers. (2-C)
Topical Dressing Selection
➤ We suggest applying a topical dressing that will manage venous leg
ulcer exudate and maintain a moist, warm wound bed. (2-C)
➤ We suggest selection of a primary wound dressing that will absorb
wound exudate produced by the ulcer (alginates, foams) and protect
the periulcer skin. (2-B)
Topical Dressings Containing Antimicrobials
➤ We recommend against the routine use of topical antimicrobial-
containing dressings in the treatment of noninfected venous leg
ulcers. (2-A)
Periulcer Skin Management
➤ We suggest application of skin lubricants underneath compression to
reduce dermatitis that commonly affects periulcer skin. (2-C)
➤ In severe cases of dermatitis associated with venous leg ulcers, we
suggest topical steroids to reduce the development of secondary
ulcerations and to reduce the symptoms of dermatitis. (2-C)
Anti-inflammatory Therapies
➤ We suggest against use of anti-inflammatory therapies for the
treatment of venous leg ulcers. (2-C)
Indications for Adjuvant Therapies
➤ We recommend adjuvant wound therapy options for venous leg ulcers
that fail to demonstrate improvement after a minimum of 4–6 weeks
of standard wound therapy. (1-B)
Split-thickness Skin Grafting
➤ We suggest against split-thickness skin grafting as primary therapy in
treatment of venous leg ulcers. (2-B)
➤ We suggest split-thickness skin grafting with continued compression
for selected large venous leg ulcers that have failed to show signs of
healing with standard care for 4–6 weeks. (2-B)
