People with blood circulation problems in their legs can develop leg ulcers. The majority of ulcers result from poor blood flow in the veins and are treated by compression.. Arterial leg ulcers occur because of poor blood supply to the legs when there is a block in a leg artery or narrowing of the arteries by atherosclerosis. Arterial leg ulcers can take months or years to heal, are painful and can become infected. Without treatment of the underlying poor arterial blood supply, ulcers take a long time to heal and may reoccur. These ulcers are treated with wound coverings (dressings) or medicines in a cream or ointment (topical agents) to promote healing and protect the wounds from infection. A variety of types of dressings are used, some keeping the wound moist and others dry. The intention is that dressings reduce ulcer pain, are easy to change and do not cause allergies or leave fragments in the wound. Topical agents are used to change the wound environment, for example ketanserin is thought to improve blood flow.
Two trials are summarized. One trial involved a total of 40 people with arterial ulcers who were randomized to either ketanserin ointment (2%) or the vehicle (polyethylene glycol) alone, administered twice a day over eight weeks. It was too small and for too short a follow-up period to be able to determine whether there was any difference in the number of ulcers healed. The time to reach 50% of initial ulcer area was estimated although it is unknown how this relates to complete ulcer healing. A second study compared lavender oil (two drops) and German chamomile essential oil (one drop) in grape seed oil as part of standard care with standard care in eight people with chronic wounds but only two had arterial insufficiency.
There are no trials in this review comparing dressings for arterial ulcers and the two small studies of topical agents provide no strong evidence for using these treatments.