BACKGROUND: Venous leg ulcers are the most common cause of chronic, non-healing ulcers of the leg. They can occur in both men and women and can take a long time to heal. The blood supply of the leg consists of blood vessels, veins that return blood from the lower legs to the heart, assisted by valves that ensure that the “one-way” upward flow of blood. When a patient has venous leg ulcers, these valves do not work properly. It will cause the blood to pool in the lower legs. It will lead to swelling and the skin will get dark, and eventually to venous leg ulcers. Patients with a history of blood clots in the leg veins (deep vein thrombosis), lower leg injury, varicose veins, obesity, patients who smoke, and patients who stand a lot are more susceptible to venous leg ulcers. (Source: http://www.nsc.gov.sg/showpage.asp?id=55)
SYMPTOMS: Venous leg ulcers can be tender and painful for patients. Patients with venous leg ulcers complain that their legs swell and ache, especially towards the end of the day. The skin on the leg can turn dark red or brown. There can be an itchy red rash with crusting and scaling. Large and small varicose veins can also be seen. Venous leg ulcers are usually just above the ankle and are wet and weepy, with heavy discharge. (Source: http://www.nsc.gov.sg/showpage.asp?id=55)
TREATMENT: Once diagnosed, venous leg ulcers can be treated with good wound care and the use of compression therapy that can improve the venous flow and decrease the selling of the legs. Compression therapy consists of “elastic” bandages that need to be applied by medical professionals. The arterial blood supply of the lower limbs must be adequate before compression therapy can be used. Once the leg ulcer is healed, it is very important to prevent recurrence by wearing support stockings. They should be replaced every 3 to 6 months or whenever the elasticity is worn out. Other important measures include: good skin care regimen, regular exercise, stopping smoking, weight management, and leg elevation above the level of the heart when lying down. If venous leg ulcers fail to heal from standard treatment, then they can become chronic wounds. (Source: http://www.nsc.gov.sg/showpage.asp?id=55)
NEW TECHNOLOGY: The University of North Carolina School of Medicine discovered that treating chronic venous leg ulcers with a topical spray that contains a living human cell formula provides a 52 percent greater likelihood of wound closure than treated it with compression bandages only. The phase II clinical trial investigated the efficacy of HP802-247 from Healthpoint Biotherapeutics. HP802-247 is a living human cell formula that consists of skin cells, keratinocytes and fibroblasts, which release growth factors into the wound on a cellular level for tissue regeneration, along with fibrinogen, which forms a “cellular web” for elasticity and blood clotting. The study enrolled 288 patients at 28 medical centers across in the United States. Two various cell concentrations two different dosing frequencies were tested with standard care along with a control group over 12 weeks. (Source: www.news.unchealthcare.org) Researchers are enrolling for phase III trials right now.