The role of pharmacotherapy in the treatment of venous leg ulcers

Abstract

Venous leg ulcers (VLU) represent the most advanced stage of chronic venous insufficiency. Their incidence increases with age. Notions of VLU treatment and prevention of recurrence remain subjects of research but also common clinical problems in daily medical practice. The lack of clearly defined principles of supportive treatment in cases of venous ulceration leads to disorderly selection of various preparations, including those which have been proven inefficient in the treatment of ulcers. The choice of pharmaceuticals in the treatment of venous leg ulcers depends to a large extent on the clinical picture but should also consider the patient’s condition and age, which are of utmost importance in the case of ulcerations. Medical therapy of VLU benefits from many drug groups with different mechanisms of action, such as non-steroidal anti-inflammatory drugs, anticoagulants, drugs affecting leukocyte function, fibrinolytic agents, and, rarely, antibiotics. Clinical studies have confirmed that healing acceleration can be achieved with the use of pentoxyphylline, sulodexide, micronized purified flavonoid fraction, and prostaglandin E1. Further studies, possibly including large patient cohorts, are necessary to explain the mechanisms of action in depth and verify the utility of various drug classes in the treatment of ulcers.

Acta Angiol 2010; 16, 4: 145–157