Page 50 - Virtual Vascular

Compression Bandages for

Chronic Venous Ulcers

Learning points:

• Venous ulcers can be extensive, slow to heal, and prone to recurrence

• Usually due to venous hypertension as a result of deep and /or
superficial venous insufficiency

• May be preceded by previous deep vein thrombosis (post-thrombotic
limb), varicose eczema, pigmentation or lipodermatosclerosis

• Ulcers have sloping edges, the base of the ulcer has slough or

granulation tissue. In severe cases, tendons or bones may be exposed

• Investigations include culture swab, biopsy (if atypical to rule out

malignancy or Marjolin’s ulcer), venous duplex, ankle-brachial pressure
index, blood tests to rule out diabetes and rheumatological disorders

• Treatment includes bed rest & elevation, frequent dressings, multi-
component (e.g.4-layer) bandaging

• Once the ulcer is healed, patient needs long term compression

stockings to prevent recurrence. Surgery should be considered to treat
the superficial venous incompetence.

• Acknowledgement to Queen Mary Hospital Surgical Wound Care Nurse
Clinic for their advice