An Integrated Solutions Approach to Venous Leg Ulcers in an Aging Population: Utilizing a Bacterial Binding Dressing, Native Bovine Collagen, and Compression

Objective:  To discuss the clinical benefits of utilizing an integrated solutions approach to treatment of venous leg ulcers utilizing a bacterial binding dressing, a native bovine collagen product and compression  in an aging population.

 The Challenge:  The aging population and prevalence of multiple co-morbidities complicate the care of patients with venous leg ulcers.  This scenario is further complicated by the microenvironment of the chronic wound, the need for compression and the importance of collagen in wound healing. This population often has some level of arterial insufficiency, where utilization of traditional multilayer wraps is inappropriate.

 The Solution:   A series of six elderly patients with venous leg ulcers were evaluated where conventional therapies and compression had not proven effective. Each wound bed was prepared with a bacterial binding dressing and a 2-layer compression system. The prepared wound bed was then ready to accept a bovine collagen product comprised of 90% Bovine Collagen (Types 1, 3, and 5) which mimics the structure of human dermis, and 10% alginate, which stimulated Type 4 Collagen for formation of the basement membrane and scaffolding

 Results:  Treatment of venous leg ulcers in an aging population with a prevalence of multiple co-morbidities and often times, arterial insufficiency was addressed. This scenario was further complicated by the microenvironment of the chronic wound, the need for appropriate compression and the requisite for a product to form the basement membrane and to act as a scaffold for new cells to cleave. The use of an integrated solutions approach utilizing a bacterial binding dressing, a bovine collagen product, and a 2-layer compression system designed for patients with arterial insufficiency, demonstrated effective in this difficult population.  Outcomes included improved patient compliance with compression, established granulation, reduced wound volume and area, no incidence of infection, and self- report of diminished pain.