Chronic venous ulcers, acetic acid treatment

Abstract

Chronic ulcers require multidisciplinary treatment and one of the most frequent complications is superinfection that slows the healing process. Our service included within the protocol of treatment of chronic ulcers, elastocompression in multilayer and use of 2% acetic acid to prevent superinfection. The objectives of this study were to describe the results of the use of acetic acid and elastocompression to prevent superinfections and achieve granulation of deep ulcers.

We studied 70 patients of both sexes, ages between 62 and 78 years (2022-2023). With active, chronic venous ulcers (greater than 6 months) of diameters between 5 cm to 10 cm. An observational-prospective study was conducted. The protocol used includes clinical evaluation, physical examination with localization of varicose gulfs, insufficient perforators, measurement of ulcer diameter and CEAP classification. Active infected ulcers at the beginning of the protocol, ulcers of arterial, neuropathic, rheumatoid and/or neoplastic origin are excluded from the present. Two groups were used: Group A: with conventional cure and group B with the addition of 2% acetic acid. The treatment involved in both groups: debridement of ulcer, healing with saline solution, use of collagenase or silver arginate + elastocompression. Only in group B is the use of 2% acetic acid added

In group B, a 90% decrease in ulcer size was observed at 4 months and in 92.5% of cases there was no superinfection in that period. In the case of group A ulcers, a 50% decrease was achieved after 4 months of treatment. In 65% of cases, episodes of reinfection requiring concomitant ATB treatment occurred.

From the present work it is objective that the use of acetic acid together with conventional healing achieves satisfactory results in the times of granulation and healing avoiding the recurrence of local infections in the ulcerous bed.   We are currently continuing to extend the protocol to the rest of the ulcers.