Performing better under pressure: a case study on the use of topical negative pressure in conjunction with a three-layer compression system for the treatment of a hard-to-heal lower leg ulcer

Abstract

Despite medical advances, chronic venous leg ulcers are still a very common and costly problem worldwide. Africa, as a continent, also faces an increase in the incidence of chronic diseases, like diabetes mellitus. The burden of venous lower leg ulcers is expected to rise with an ageing population and the growing epidemic of diabetes mellitus and obesity. This, coupled with chronic venous insufficiency, reduces quality of life and increases healthcare costs as these ulcers may take a very long time to heal. Little data are available on the prevalence of or treatment regimens for patients with venous lower leg ulcers in South Africa. The aim of this case study was to report on the effectiveness of combining the current gold standard for venous lower leg ulcer treatment (compression therapy) with topical negative pressure (TNP) therapy to treat a large surface area lower leg ulcer that was not responding to treatment. This combination treatment not only improved the outcome for the specific patient, but demonstrated that topical treatment alone is insufficient. In addition, associated exacerbating factors must be addressed when managing lower leg ulcers.