The Leg Ulcer Charity was quoted in the Mail on Sunday today. (see: http://www.dailymail.co.uk/health/article-3783129/An-excruciating-leg-ulcer-Pile-pressure-remove-pain-say-experts.html). The subject was an Italian research paper, reporting on treatments for venous leg ulcers.

The Leg Ulcer Charity quoted in The Mail on Sunday 11th September 2016.

The Leg Ulcer Charity quoted in The Mail on Sunday 11th September 2016.

The ramifications of this work are quite profound and will change the lives of many patients with venous leg ulcers. Reporter Sara Malm wrote an excellent review of this. Prof Mark Whiteley was asked for comments on a new study, as the founder of the Leg Ulcer Charity.

The study:

The study was performed at a major venous research centre in Italy. Researchers had compared patients with purely venous leg ulcers and those with venous leg ulcers and mild arterial disease.

It is already known that compression itself will help heal ulcers in the short term, but unless the underlying veins are also treated, the ulcers will not be cured permanently.

These researchers use ultrasound guided foam sclerotherapy to the underlying veins in both groups of patients.

However, whereas it is usual to use compression bandaging for purely venous ulcers, most nurses working with ulcers will not put compression on patients with arterial disease.

This study showed that provided the compression is kept under 40 mmHg, it is safe to use compression in these patients. With the addition of foam sclerotherapy followed by compression, it is possible to both heal and to cure venous leg ulcers.

Most importantly, the research study showed two main things. Firstly it is safe to use compression in patients with moderate arterial disease (defined as pressure ratios 0.5 to 0.8). Secondly, these patients healed almost as fast as those with purely venous ulcers using the same regime.

Ramifications for patients with leg ulcers:

Compression of the legs is essential for patients with venous leg ulcers. It helps reduce the swelling and increase the ankle range of movement in the short term. However, to cure leg ulcers permanently, the underlying vein problem needs to also be treated. This might be by endovenous laser, TRLOP closure of perforators and/or ultrasound-guided foam sclerotherapy. Rarely veins need to be opened with stents.

However, even with these curative techniques, compression is often needed before treatment to control swelling and after treatment until healing has taken place.

This study has shown that more patients can have compression treatment than had previously been thought.