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Nonoperative Management of Venous Leg Ulcers: Evolving Role of Skin Substitutes

Chronic venous leg ulcers markedly influence the physical, financial, and psychologic wellbeing of patients and result in an estimated 2 million lost workdays annually. Despite a wide variety of therapeutic options, venous leg ulcers remain a substantial management challenge to health care professionals. Although no consensus on compression therapy exists, it remains a primary treatment of edema and ulceration secondary to venous disease. Recently, biotechnology-derived skin substitutes have been developed to help stimulate local wound healing. These range in composition from an epidermal or dermal layer to a complete, bilayered living skin construct. This review focuses on nonoperative treatment options for venous ulcers, particularly the evolving roles of newer treatment options including skin substitutes and growth factor/cytokine preparations. The development and characteristics of these emerging therapies as well as clinical experience with and options for their use in the treatment of chronic venous ulcers are reviewed.

Vascular and Endovascular Surgery, Vol. 33, No. 2, 197-210 (1999)
DOI: 10.1177/153857449903300217


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