Management and prevention of venous leg ulcers: a literature-guided approach.

Managing venous leg ulcers involves management techniques that are indicated both in the treatment of all chronic leg ulcers and those that are specific to venous leg ulcers. The first step in managing venous leg ulcers is performing a holistic assessment of the patient. Once this is complete, any systemic or local factors that may affect wound healing should be addressed. This approach to managing the whole patient is critically important because if significant general wound healing factors are not treated, other specific attempts at healing the venous ulcer will be fruitless. This paper reviews nutritional supplementation, wound bed preparation, antimicrobial therapy, venous insufficiency, compression therapy, different bandage systems, therapeutic adjuncts to compression therapy, and recent advances in vascular surgery. Recurrence prevention also is discussed.