Treatment of venous ulcer: part 3

Occlusive dressings: There are hundreds of dressings on the market for treatment of venous ulcers. Each company hypes up claims that their product is the best at healing venous ulcers. However, in reality, there is no difference among these occlusive dressings. Many of these occlusive dressing have fancy chemicals and antibiotics impregnated in them, -some even claim to have healing growth factors. In reality all these dressings work in the same way and there is no difference in healing time. One should be aware that the latest occlusive dressing with fancy antibiotics are exorbitantly expensive and there is no evidence that they can heal a venous ulcer faster than a simple wet gauze and a compression bandage.

Skin grafts: In a few people, the venous ulcer does decrease in size but does not completely close. As long as the ulcer is open, one may still feel pain. For these individuals an option is to close the open wound with a skin graft. However, skin graft will only work if the venous pressure is treated at the same time. Skin grafts fail in each and every case if the venous pressure is not controlled. Skin grafts are generally applied by plastic surgeons. The procedure is painful, requires skin from another part of the body and bed rest for a 1-2 weeks is required. It is imperative that the plastic surgeons treat both the varicose veins and the ulcer at the same time to ensure that the skin graft works.

Almost every wound clinic in North America claims to have growth factors that can help heal venous ulcers. Growth factors do work but only in a few cases. In the majority of cases, growth factors are over utilized and are not required for healing of venous ulcers. These expensive exotic treatments are never required if one first controls the venous pressure. A venous ulcer will heal if the pressure inside the vein is decreased. Growth factors are generally useful for more resistant ulcers induced by radiation.