Chronic venous leg ulceration: healing is more than skin deep

Chronic venous leg ulcerations (CVLUs) are very prevalent from a global standpoint. These ulcerations are challenging to heal and have a recurrence rate as high as 70%.¹ The consensus is that a successful healing regimen should include managing tissue, infection/inflammation, and moisture balance within the wound bed, along with appropriate compression therapy. It is also extremely important for patients with CVLUs to be treated by a multidisciplinary team, including a thorough vascular evaluation of both the venous and arterial system. Despite the advances made in both vascular surgery and wound care techniques, CVLUs are still a challenge for patients and health professionals.

In wound care centres and clinics, the plan of care is mainly focused on the breach in skin integrity; but perhaps the bigger picture is being missed? Having a chronic condition, such as a leg ulceration, affects a patient not just in the physical sense—it also has a psychological and social impact. Enduring the stress of coping with a CVLU has a continued negative influence by impairing the immune system which further impedes wound healing.² Strategies have been introduced in recent years to aid in addressing these quality of life matters for patients with a CVLU. Green et al. designed a template to be used for patient input during consultation with their healthcare team regarding their ability to socialise with respect to mobility, sleep quality, pain level, hygiene issues, personal relationships and fear of odour.³ This model provides a more holistic and patient-centred approach by providing support at all levels.