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This case study highlights the successful resolution of a chronic venous leg ulcer in Patricia P., a 55-year-old female with a medical history of hypertension and chronic tobacco use. Venous leg ulcers are notoriously difficult to manage due to underlying venous insufficiency, but with a structured, multidisciplinary approach, Patricia’s wound achieved full closure within four months.

Patient Profile

• Name: Patricia P.

• Age: 55

• Gender: Female

• Medical History: Hypertension, chronic tobacco use

• Diagnosis: Chronic venous leg ulcer, secondary to venous insufficiency

Objective

The primary objective of this case was to document the complete healing of a chronic venous ulcer, emphasizing wound management, vascular evaluation, patient education, and long-term prevention.

Treatment Protocol

1. Comprehensive Wound Assessment
Patricia underwent a detailed wound evaluation, including:

• Thorough wound history and documentation

• Ankle-Brachial Index (ABI) testing to assess arterial circulation

• Observation for venous pigmentation and skin changes indicative of venous disease

2. Vascular Studies
Given a normal ABI and palpable peripheral pulses, venous Doppler ultrasound and reflux studies were performed to rule out:

• Deep vein thrombosis (DVT)

• Venous reflux

• Underlying infection

3. Skin and Infection Management

• Cellulitis was treated and resolved

• Daily skin moisturization was implemented to improve skin barrier function

4. Nutritional and Lifestyle Interventions

• Dietary recommendations were tailored to support wound healing and manage hypertension

• Strong emphasis was placed on tobacco cessation

• Lifestyle modifications were encouraged to support vascular health

5. Wound Management

• Regular wound debridement and bioburden control

• Use of moist wound dressings to optimize the healing environment

• Weekly assessments to monitor progress

6. Edema Control
To address venous edema and prevent worsening:

• Leg elevation and movement were encouraged

• Compression bandages were applied

• Lymphedema care was initiated for phlebolymphedema

7. Advanced Therapies

• Ultramist Therapy: Applied 1–2 times per week to stimulate tissue regeneration

• Amniotic Tissue Application: Used for its regenerative properties, covered with a non-adherent layer and sealed with moisture-retentive dressings

8. Prevention and Maintenance Plan
A long-term prevention strategy included:

• Graduated compression stockings

• Routine leg elevation and offloading

• Ongoing lifestyle and behavioral modifications

Results

• Initial Response: Signs of healing were visible at the first dressing change

• 3 Weeks: Notable reduction in wound size and improvement in tissue quality

• 7 Weeks: Substantial wound contraction and granulation

• 4 Months: Full wound closure achieved, with restored skin integrity and no signs of infection or recurrence

Conclusion

This case illustrates the successful resolution of a chronic venous leg ulcer in a high-risk patient through a comprehensive, evidence-based treatment approach. The integration of vascular assessment, advanced wound therapies such as amniotic tissue and Ultramist, and aggressive lifestyle modification led to full healing within four months. This case underscores the importance of individualized, multidisciplinary care in managing chronic venous ulcers and preventing recurrence.