Compression Therapy Challenges and Ulcer Recurrence in Chronic Venous Insufficiency: A Case Report and Review of Management Approaches

Chronic venous insufficiency (CVI) is a major cause of recurrent venous leg ulcers (VLUs) and presents treatment difficulties for elderly patients. This case report describes an 88-year-old female with CVI, cardiomyopathy, hypertension, dyslipidemia, and left-sided hemiplegia who presented with a 10-day history of left lower leg tenderness and purple-red discoloration. Examination revealed bilateral varicosities and a stage 4 VLU over the medial malleolus with purulent drainage and surrounding erythema. After 12 days of compression therapy, the ulcer improved to stage 3. However, two months of non-adherence to the treatment led to recurrence with a new stage 2 ulcer. The patient was subsequently initiated into a structured program with demonstrations, written instructions, scheduled reminders, and weekly follow-ups. After 22 days of consistent compression therapy, the ulcer improved to stage 1. This case emphasizes the importance of consistent compression therapy and multifaceted approaches in managing recurrent VLUs.