In stasis dermatitis with venous ulcer of the lower extremity, the primary clinical goal is healing of the ulcer. When standard first-line treatment does not reach that goal, a defined next-line approach is available.
First-line standard treatment — which includes compression therapy, topical dressings, oral analgesics, topical anesthetic creams, topical pentoxifylline and phlebotonics, and antibiotics or antiseptics — targets reduction of pain and edema of the lower extremities and healing of the venous ulcer.
When these goals are not achieved, a further treatment step is warranted.
Venous ulcer of the lower extremity in a patient with stasis dermatitis where first-line compression-based and wound-care management has not resulted in ulcer healing or adequate control of symptoms.
At this stage, surgical interventions become a consideration. The full protocol specifies which options apply, their indications, and additional considerations for patients with recurring ulcers. The treatment goal remains healing of the venous ulcer.
DOI: 10.1007/s40257-022-00753-5
In the case of venous ulcers, treatment options include management, mechanical modalities, wound therapy, medications, and/or surgery.
Surgical options, which include endovenous ablation and skin grafting, can also be utilized to promote healing and prevent ulcer recurrence.
In patients with recurring ulcers, the addition of ablative superficial surgery to standard treatment may be an option.
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