Dressing

No specific wound dressing has been shown to improve the rate of healing of venous leg ulcers (1).

Simple non-adherent dressings are recommended in the management of venous leg ulcers (2)

• dressing is applied and replaced weekly, unless heavy exudate requires more frequent bandage changes
• in case of infected venous leg ulcer, a low-adherent dressing is applied and replaced on a daily basis to assess whether the infection is improving (3).

Types of wound dressing include:

• gauze, which may be impregnated with foams or antimicrobials
• hydrocolloids
• transparent films
• hydrogels
• foams
• alginates (derived from seaweeds)
• antimicrobials - iodine, alcohol, chlorine
• collagen (1)

There is some evidence that specific dressings may help achieve some secondary clinical goals:

• relief of pain:
  • occlusive and semi-occlusive dressings may be better
• absorption of exudate & protection of surrounding skin:
  • gel and hydrocolloid dressings are better
• odour reduction:
  • dressings with metronidazole and/or charcoal may help

Routine long term use of topical antiseptics and antimicrobials is not recommended (2).

Reference:

• (1) van Gent WB, Wilschut ED, Wittens C. Management of venous ulcer disease. BMJ. 2010;341:c6045.
• (2) Scottish Intercollegiate Guidelines Network (SIGN) 2010. Management of chronic venous leg ulcers
• (3) Clinical Knowledge Summaries 2008. Leg ulcer-venous