When chronic venous insufficiency progresses to venous leg ulcers of the lower extremities, management requires a structured, protocol-driven approach. The following outlines the clinical scenario and the key elements of evidence-based care for this population.
Patients with venous leg ulcers of the lower extremities — a serious complication of chronic venous insufficiency in which sustained venous hypertension results in persistent, often recurrent wounds requiring targeted intervention.
Management is built around compression therapy — with evidence indicating that stronger grades may confer greater benefit — combined with comprehensive wound care. The complete regimen, including additional therapeutic components and sequencing, is detailed in the full protocol.
The primary clinical target is an increased rate of venous ulcer healing at 12 months.
DOI: 10.1016/j.jscai.2025.103729
For patients with venous ulcers, the SCAI guideline panel recommends compression therapy rather than no compression therapy (strong recommendation, moderate certainty of evidence).
Compression therapy for venous ulcers and comprehensive wound care are feasible and necessary, but supplementary ablative therapy may be needed to achieve faster and higher rates of ulcer healing.
Stronger grades of compression therapy may be more effective.
Compression bandages or stockings were associated with a probable increase in the rate of ulcer healing compared to no compression at 12 months (RR, 1.77; 95% CI, 1.41-2.21).
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