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Treatment requires expert nursing care and consists of getting the wound clean and then stimulating skin to cover the wound as well as treating the underlying venous disease.
The wound is cleaned (or debrided) by a combination of three techniques:
Skin cover is obtained by either a skin graft or waiting for the clean wound to heal on its own.
Making a skin graft
The venous disease is managed with compression dressings and removing any superficially diseased veins
Before applying the compression dressings the wound is cleaned
A protective “cream” layer is then applied and then compression dressings are applied.
The degree of compression depends on the dressing and the person putting it on. Ideally it should not be applied if there is any compromise to the arterial blood supply to the leg as is confirmed with normal ankle pulses checked with a Doppler ultrasound.
Doppler pulse check of arterial blood supply
Once the ulcer is healed it is important to continue to wear support stockings to reduce the risk of it coming back