In Patients with Chronic Venous Ulcer Is the Unna Boot Still the Best Approach to Wound Care

Abstract

Of the four most common causes of lower extremity ulcerations (including arterial insufficiency, neuropathy, pressure and ischemia, and venous insufficiency), venous insufficiency is the most frequent, accounting for nearly 80 % of all lower leg ulcers. That number correlates to approximately one million people of the seven million that have venous insufficiency in the United States [1]. These lesions appear to be more common in women than men and are most frequently seen in patients between the ages of 60–80. However, according to Nelzen et al. [2] in their survey of the epidemiology of venous ulcerations, 22 % of individuals have their first ulcer before the age of 40. The Unna’s Boot Compression System, first developed by the German dermatologist Paul Gerson Unna, has been considered the standard of treatment for venous leg ulcerations since its inception in 1986 [3]. While compression therapy is still the key to healing venous leg ulcerations, there is evidence to suggest that multi-layered elastic bandages versus the rigid, inelastic Unna’s boot bandages, have become the current mainstay of therapy.