Does social support impact on venous ulcer healing or recurrence?

Graduated, sustained high compression therapy is now widely acknowledged as the ‘gold standard’ treatment for venous ulceration.¹ Excellent healing rates are generally achievable, however, some venous leg ulcers refuse to progress to healing despite appropriate management. In addition, some venous ulcers recur frequently despite the wearing of prophylactic compression hosiery.²

Several authors have described improved healing rates and a reduction in recurrence when patient education and contact with health professionals is maintained through leg ulcer clinics.^3,4,5,6 This suggests that other factors, such as psychosocial issues in addition to appropriate clinical management, may impact on successful wound healing and prevention of recurrence.

In the absence of corrective surgery, chronic venous hypertension can be classified as a long term condition, ‘that is currently not curable and therefore can only be managed,⁷ although it is not generally acknowledged as such. There is an extensive body of literature which focuses on the psychosocial issues that impact negatively on the quality of life of patients with long term conditions, such as diabetes or arthritis.^8,9 Factors such as the emotional impact of pain, social support, coping mechanisms and response to stress and treatment adherence have been identified. Healthcare professionals are becoming increasingly aware of the impact psychosocial issues may have on wound healing in general,^10,11 but particularly, in chronic venous leg ulceration and prevention of recurrence.^12,13