Venous Ulcers

Open valve: Blood can flow towards the heart.
Closed valve: Blood cannot flow back towards distal.
Deficient valve: Allows the venous blood to flow back.

How do venous leg ulcers develop?

Venous insufficiency is the most common underlying cause of a venous leg ulcer. The compromised blood flow to the heart is mainly caused by venous valve incompetence. The resulting reflux leads to an ambulatory venous hypertension which also extends into the capillaries. As a consequence, nutrients and oxygen are unable to diffuse to the skin, causing death of skin tissue and the development of a venous leg ulcer.

Where do venous leg ulcers develop?

Venous leg ulcers are most often located on the inside of the lower leg. Approximately 80% of ulcerations are located around the ankle and behind the malleolus. They can be difficult to heal and require a comprehensive therapeutic approach which also tackles the underlying disease.

Effective, healing therapy considers many treatment elements.

Professional wound treatment of a venous leg ulcer is not the only component of healing. Due to the impairment of the venous blood flow, adequate compression therapy is a must and skin care products are necessary to help the skin recover from mechanical stress. To ensure venous leg ulcer therapy is effective, risk factors such as excess weight and smoking must also be taken into account.

Why compression?

Adequate compression is necessary whenever venous flow is impaired. In the severe stages of chronic venous insufficiency, sustained compression of 40 mmHg* or more at the ankle is the recommended pressure to support venous return. At this point, the specific stiffness of a compression device becomes a crucial factor.

The higher the stiffness, the higher the working pressure and the effect of the muscle pump. Known for their high stiffness, compression bandages are indicated for the reduction of edema, whereas stiff stocking systems offer higher patient compliance during the acute phase as soon as the edema is reduced. After healing the ulcer patients are required to apply adequate compression for the rest of their lifes (e.g. wearing compression hosiery).

Differential diagnosis: venous or arterial ulcer?

Compression would be strictly contraindicated in case of arterial leg ulcers. In order to exclude an underlying arterial disease the patient’s ABPI (Ankle Brachial Pressure Index) should be assessed.

  • >0,8 = venous ulcer -> sustained compression of 40 mmHg
  • 0,5-0,8 = mixed ulcer -> compression only after consulting a vascular specialist
  • <0,5 = arterial ulcer -> compression is strictly contraindicated Once arterial disease is excluded, ensure adequate compression is applied:
  • with sustained compression of 40 mmHg
  • with bandages or stockings, depending on whether edema is also present.

JOBST® UlcerCARE™ enables effective management of a venous leg ulcer while offering ease of use at the same time – the perfect combination for providing patients with a higher quality of life.

How does a 2-in-1 compression system work?

The JOBST® UlcerCARE™ liner facilitates the application of the JOBST® UlcerCARE™ outer stocking and holds the wound dressing in place. During bed rest the liner provides mild compression to manage minor edema. Worn together, the liner and the outer stocking provide the optimum compression of 40 mmHg, which is the targeted nominal compression to heal venous leg ulcers*, while offering a high stiffness.

Supporting therapy success by encouraging patient compliance:

JOBST® UlcerCARE™ is designed for patient self-management. By facilitating easy dressing change and improved personal hygiene (e.g. bathing), a patient is more likely to be compliant. Also compatible with common footwear and clothing, JOBST® UlcerCARE™ helps support a normal lifestyle.