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Leg ulcer - venous - Management
How should I dress an infected venous leg ulcer?
- Dressings should be applied by a healthcare professional trained in venous ulcer management.
- Wound dressing: apply a low-adherent dressing and replace on a daily basis to assess whether the infection is improving:
- Alternative dressings may be considered to help with pain (hydrocolloid), heavy exudate (alginate), or slough (hydrogels).
- Do not use antimicrobial dressings.
- Compression therapy: do not start compression therapy if the ulcer is infected. If a leg ulcer becomes infected and compression bandaging is being used, remove the bandaging, and restart compression therapy once the infection has resolved.
Clarification / Additional information
- Wound dressings that create and maintain a clean, moist microenvironment are now considered optimal for wound healing. Low adherent dressings are cheap and widely available. Their major function is to allow exudate to pass through into a secondary dressing while maintaining a moist wound bed to facilitate healing.
- Compression therapy should preferably be removed if the ulcer becomes infected. Compression therapy may be too painful for an infected ulcer that is already tender, and the daily inspection needed will make compression bandaging impractical.
Basis for recommendation
- These recommendations are based on clinical guidelines: The nursing management of patients with venous leg ulcers published by the Royal College of Nursing [RCN, 2006], together with the best available trial evidence and informed expert opinion, and reflects current good clinical practice.
- Wound dressings aid healing, improve comfort, and control exudate. Their role in maintaining moisture facilitates autolytic debridement and promotes healing [Jones et al, 2006]. There is insufficient evidence to show that any wound dressing (including dressings impregnated with silver) is better than simple low-adherent dressings for the healing of venous leg ulcers [Palfreyman et al, 2006; RCN, 2006].
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