The impact of venous leg ulcers on patient quality of life

Venous leg ulcers (VLUs) are common wounds that can deeply affect patient quality of life. Although challenging to healthcare systems due to their chronic nature, hard-to-heal wounds like VLUs pose challenging side effects. Among these are exudate management and potential leakage as well as the need for more frequent – and potentially traumatic dressing changes and pain. All of these cause a range of stressful emotions for patients, including distress, embarrassment, and anxiety. The management of venous leg ulcers is about more than just the physical wound for patients: it is also psychosocial. How can various interventions, including wound dressing selection, play a role in minimising distress and pain and improve patient wellbeing?

It is important to note, though, that venous leg ulcer management and VLU treatment is changing, and the outlook is improving. There are considerations and interventions to help raise the bar on VLU care and minimise the burden of VLUs to both healthcare systems and to patients.

Focusing on more effective wound management for better patient quality of life

With VLUs, patients face longer and atypical healing journeys, high levels of wound exudate (which can lead to embarrassing leakage, skin maceration and odours as well as immobility and social isolation), pain, and more. The high rate of recurrence (50-70%)¹ can lead to longer term psychosocial effects, such as depression, anxiety, self-esteem issues, and a decreased health-related quality of life.^{2, 3, 4}

Daily life for people living with highly exuding wounds like VLUs poses many challenges that largely stem from issues with exudate. Many patients find that they worry about exudate leakage, causing oiled garments and medical devices, unpleasant odours, and unappealing visual appearance. The resulting embarrassment and distress may keep them from living their fullest lives. More longer-term concerns include the increased risk of infection, discomfort, skin damage around the wound from leakage and maceration, the potential for the wound to expand, increased pain, and longer time to heal.

This collection of side effects can be life changing in a negative way, manifesting in all manner of ways, including self-isolation, distress, and depression. Quality of life is an ongoing concern for people living with VLUs and should also be a bigger focus for healthcare providers.

Considerations for VLU management: Quality of life improvements

How can quality of life be better addressed through more effective VLU management?

A Wounds International article, co-written by Dot Weir, RN, Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine and Mölnlycke Health Care’s Global Senior Medical Affairs Manager, Phil Davies, addresses the considerations for care as well as how dressing selection plays an important role not only in wound healing but in giving patients back their quality of life.

The article advocates for improved treatment and care, focusing on areas such as managing chronic venous insufficiency and venous hypertension with compression therapy as the “gold standard” of conservative treatment.

At the same time, the holistic approach to VLU care advocates for careful exudate management to avoid not just the physical side effects of exudative wounds and leakage but also the psychological ones – such as the worry, embarrassment, and loss of self-esteem that patients report experiencing.

Dressing selection is another key consideration in the VLU management journey. Appropriate dressings can perform in conjunction with compression therapy while also managing exudate to prevent embarrassing leakage and further impact to skin, minimising dressing-related pain and trauma, and avoiding unnecessary dressing changes, all of which contribute to a better quality of care, an improved quality of life and restoration of patient confidence.

The article is featured in Wounds International and can be read in full here - Read the full article to find out more about VLU management and patient quality of life.