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New Adjunctive Treatment Option for Venous Stasis Ulcers

Adding simvastatin to standard wound care improves ulcer healing rates and times, as well as the patient’s quality of life.

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PRACTICE CHANGER
Consider adding simvastatin (40 mg/d) to standard wound care and compression for patients with venous stasis ulcers.1

STRENGTH OF RECOMMENDATION
B: Based on a high-quality randomized controlled trial (RCT).1

ILLUSTRATIVE CASE
A 74-year-old woman with chronic lower extremity edema seeks treatment for a nonhealing venous stasis ulcer. For the past nine months, she’s been wearing compression stockings and receiving intermittent home-based wound care, but nothing seems to help. She asks if there’s anything else she can try.

Venous stasis ulcers affect 1% of US adults and lead to substantial morbidity and more than $2 billion in annual health care expenditures.1,2 Edema management—generally limb elevation and compression therapy—has been the mainstay of therapy. Treatment can be lengthy, and ulcer recurrence is common.2,3

Statins have been found to aid wound healing through their diverse physiologic (pleiotropic) effects. Evidence indicates they can be beneficial in treatment of diabetic foot ulcers,4 pressure ulcers,5 and ulcerations associated with systemic sclerosis and Raynaud phenomenon.6 Evangelista et al1 investigated whether adding a statin to standard wound care and compression could improve venous stasis ulcer healing.

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