Wound Care for Venous Leg Ulcers
Venous leg ulcers are one of the most challenging complications of chronic venous insufficiency, and they often affect mobility, independence and quality of life. These open wounds typically develop near the ankles, where venous pressure is highest, and refuse to heal through standard wound care alone.
At Prevosti Vein Center, Dr. Louis Prevosti’s comprehensive approach addresses the underlying circulation problem while providing treatment for chronic leg wounds and skin breakdown. With over 30 years of cardiovascular expertise and 15 years focused exclusively on vein disorders, Dr. Prevosti has successfully treated many patients with venous ulcers.
What Is Wound Care for Venous Leg Ulcers?
Wound care for venous ulcers involves specialized techniques that promote healing while treating the venous insufficiency causing the wound. Unlike treatment for wounds from a different cause, venous ulcer care requires specific compression therapy, specialized dressings and targeted vein procedures to eliminate the root cause of poor healing and to prevent recurrence.
Venous ulcers develop when chronic high pressure in damaged veins causes chronic inflammation, tissue fibrosis and, ultimately, skin breakdown. Venous ulcers typically occur on the inner ankle or lower calf. These wounds persist because the ongoing venous pressure prevents regular tissue repair. Dr. Prevosti combines immediate wound management with minimally invasive vein treatments to restore healthy circulation and enable healing.
How Does Specialized Wound Care Work?
Unna Boot Application
The cornerstone of venous ulcer treatment is the Unna boot, a specialized compression dressing named after German dermatologist Dr. Paul Gerson Unna. This medicated gauze bandage contains zinc oxide, glycerin and other products that promote healing while the dressing provides firm compression to combat the venous pressure. Dr. Prevosti and his team apply the Unna boot to deliver consistent pressure that reduces venous pooling and edema while keeping the wound moist for optimal healing. Dr. Prevosti’s protocol is to change the Unna boot weekly.
The Unna boot provides "inelastic compression,” as opposed to the typical elastic compression of compression stockings. Inelastic compression is useful in patients with advanced skin changes and especially for patients with venous ulcers. Inelastic compression garments allow for higher pressure compression when the patient is upright and lower pressure when the patient reclines.
Who Needs Wound Care for Venous Ulcers?
Patients with open wounds on the lower legs, particularly near the ankles, should seek evaluation from a vein specialist. Venous ulcers have distinct characteristics that Dr. Prevosti recognizes through his extensive experience.
Key indicators of venous ulcers include:
- Location just above the inner or outer ankle or lower ⅓ of the calf
- Irregular wound borders with shallow depth
- Surrounding skin may be hard
- Surrounding skin may have a brown discoloration (hemosiderin staining)
- Weeping or drainage from the wound
- History of leg swelling, varicose veins or previous DVT
Dr. Prevosti's thorough evaluation differentiates venous ulcers from wounds caused by arterial disease, diabetes or other conditions requiring different treatment approaches. His diagnostic ultrasound examination reveals the specific patterns of venous insufficiency contributing to poor wound healing.
What to Expect From Treatment
Initial Evaluation
Your first visit involves a comprehensive assessment of the ulcer and underlying venous disease. Dr. Prevosti examines the wound characteristics, surrounding skin changes and leg circulation. Diagnostic ultrasound imaging maps your venous system to identify which veins require treatment to eliminate the high pressure preventing healing.
Dr. Prevosti's compassionate approach helps patients feel comfortable discussing their health, wound history and previous treatment attempts. He explains how addressing venous insufficiency while managing the wound provides the best opportunity for complete healing.
Treatment Planning
Based on his evaluation, Dr. Prevosti develops an individualized treatment plan. Initial wound management often begins immediately with Unna boot application or other appropriate dressings. He schedules minimally invasive vein treatments to address the underlying cause while wound care continues.
This integrated approach means patients receive coordinated care at one location. Dr. Prevosti personally oversees every aspect of treatment, from wound dressings to vein procedures.
Ongoing Wound Management
Regular dressing changes allow Dr. Prevosti to monitor healing progress and modify treatment as needed. Most patients require weekly visits initially, with intervals extending as the ulcer improves. He may adjust compression strength or change dressing types.
Minimally Invasive Vein Treatments
While wound care manages the ulcer itself, lasting healing and preventing recurrence requires eliminating the venous insufficiency causing excessive pressure. Dr. Prevosti employs several minimally invasive techniques performed in his Canton office, including:
- Radiofrequency ablation to seal malfunctioning saphenous veins
- Endovenous laser ablation for precise treatment of damaged veins
- Ultrasound-guided foam sclerotherapy to eliminate damaged tributary and reticular veins
- VenaSeal™ adhesive closure for patients requiring rapid mobilization
- Varithena® injectable foam therapy for treating various sizes of varicose veins
- Ambulatory micro-phlebectomy to remove superficial varicose veins near the ulcer site
These procedures, performed under local anesthesia, allow patients to walk immediately afterward while continuing wound care. Dr. Prevosti's extensive experience enables him to select the optimal combination of treatments for each patient's anatomy and ulcer characteristics.
Recovery and Long-Term Management
Healing time varies based on ulcer size, duration and patient factors, but most venous ulcers show significant improvement within a month when underlying vein disease is properly treated.
After complete healing, preventing recurrence requires ongoing attention to leg health. Dr. Prevosti prescribes appropriate compression stockings and provides guidance on skin care, activity levels and warning signs of potential problems. His long-term follow-up helps patients maintain healthy legs after ulcer resolution.
Why Choose Dr. Prevosti for Venous Ulcer Care
Dr. Prevosti offers unique advantages for patients with venous ulcers, including:
- Comprehensive expertise: Board certification in cardiovascular surgery plus specialized vein credentials (ABVLM Diplomat, RPVI, RPhS)
- Integrated treatment: Wound care and vein procedures performed by the same physician in one location
- Proven experience: Tens of thousands of successful vein treatments, including complex ulcer cases
- Personal attention: Dr. Prevosti personally performs all evaluations, procedures and wound care
- Insurance navigation: In-house staff familiar with coverage for both wound care and vein treatments
Heal Your Venous Ulcer at Prevosti Vein Center
Living with a chronic leg wound affects every aspect of daily life. Dr. Prevosti's comprehensive approach to venous ulcer treatment addresses immediate wound needs while correcting the circulation problems preventing healing. His compassionate care and extensive expertise help patients achieve wound closure and return to active lives.
Contact Prevosti Vein Center today to schedule your evaluation. Let Dr. Prevosti's specialized wound care expertise guide you toward complete healing and lasting leg health.