Lower-leg ulcer management
Venous, arterial and mixed lower-limb ulcers: compression, debridement, and topical treatment.
What it is
Chronic lower-leg ulcers — open wounds below the knee that fail to heal within 4–6 weeks. Aetiology: venous insufficiency (~70%), arterial insufficiency (~10%), mixed and rarer causes (~20%). Correct aetiologic diagnosis drives the plan — compression is contraindicated when ABI < 0.5.
What it looks like in practice
3 real-world cases from clinics using Flaminal® — before/after photos, treatment protocol, and healing timelines.
Real clinical cases from the practice of partner clinics using Flaminal® in Uzbekistan. Patient personal data is not published.
CEAP classification for venous disease
C0–C2
No signs (C0), telangiectasias (C1), varicose veins (C2). No ulcer.
C3
Oedema without skin changes.
C4
Pigmentation, eczema, lipodermatosclerosis, atrophie blanche — pre-ulcerative skin.
C5
Healed ulcer — high recurrence risk.
C6
Active venous ulcer.
Treatment principles
Aetiology workup
ABI, venous and arterial duplex ultrasound. Without these, dressing and compression choice is blind.
Compression therapy (venous)
Multi-component compression at 30–40 mmHg is the gold standard for venous aetiology. Contraindicated when ABI < 0.5.
Debridement and microbial-load control
Remove slough and necrosis. Antiseptics and topical antimicrobials for critical colonisation.
Moist environment
A modern alginate or gel dressing under the compression bandage. Change every 1–4 days.
Flaminal®'s role
Flaminal® acts as the primary dressing under compression. Enzymes break down slough at the wound bed; alginate absorbs exudate. Atraumatic dressing change matters — venous-ulcer changes are often the most painful event of the week, and the gel removes that barrier.
Flaminal Forte
Heavy exudate.
Flaminal Hydro
Low exudate.
Studies
Long-term Flaminal® therapy for venous leg ulcers
Beele H., Meuleneire F. et al. · Wounds International · 2018
On requestAlginate dressings: systematic review of clinical effectiveness
Dumville J.C. et al. · Cochrane Database of Systematic Reviews · 2017
On requestCEAP classification update — venous disorders
Lurie F. et al. · Journal of Vascular Surgery: Venous and Lymphatic Disorders · 2020
On request
Further reading
More on the manufacturer's site
Flen Health maintains a detailed topic page with clinical cases. Opens in a new tab.