TREATMENT AND PROGNOSIS :
The main aim of the treatment is provide the keen areas which favours the growth of the skin in an ulcer area. In majority of cases this requires finding and treating underlying venous reflux. Most venous ulcers respond to patient education, elevation of the foot, elastic compression and evaluation which is known as Bisgaard regimen. Exercises along with compression stocking increases the process of healing. There is no evidence that antibiotics whether administered intravenously or by the mouth are very much useful. Silver products are also not useful.
Non elastic, below knee compression counters the impact of reflux on venous pump failure.
Compression therapy restricts the back flow of the blood. It is also useful to decrease the release of inflammatory cytokines, lower the amount of the fluid leaking from capillaries and therefore prevent swelling and also prevents the clotting by decreasing the activation of thrombin and increasing that of plasmin. Compression is applied using the elastic bandages or boots which are specifically designed for this purpose.
Pentoxifylline is useful in the treatment of the compression stockings . it reduces the platelet aggregation and reduces the thrombus formation. Sulodexide also reduces the formation of the blood clots and reduces the inflammation and promotes the healing of the venous ulcers.
Aspirin can also be used which provides the better relief.
Wound cleaning solutions:
Wound cleansing solutions such as polyhexamathylene biguanide, aqueous oxygen peroxide are better than sterile water or saline solutions in the healing of the venous ulcer.
Skin grafts and artificial skin:
Skin grafts which are made artificially from the collagen and cultures skin cells is also used to heal the venous ulcer.
Thermo ablation , laser ablation and radiofrequency, perforator closure and foam sclerotherapy is useful in the healing the ulcer.
Silver containing dressing increases the chances for healing the ulcers.