Specialized Treatment
Mobile venous leg ulcer treatment specialists serving Los Angeles, Orange County, Riverside, San Bernardino, Ventura, Santa Barbara, and Kern County. Expert care for venous stasis ulcers caused by chronic venous insufficiency (CVI) with compression therapy, multilayer bandaging, wound debridement, skin substitutes (Apligraf, Dermagraft, amniotic membrane), infection control, and edema management. Board-certified wound care specialists provide in-home treatment for venous ulcers above the ankle. Medicare Part B covered mobile wound care serving 90210 Beverly Hills, Anaheim, Irvine, Riverside, San Bernardino, Oxnard, Santa Barbara, and Bakersfield.
70-90% of all leg wounds are venous ulcers. They're the most common chronic wound type in America (2+ million cases). And here's what most doctors won't tell you directly: If you won't wear compression daily for the rest of your life, your ulcer will never permanently heal.
The Numbers Don't Lie:
Venous ulcers are mechanical failures, not just medical problems. Your leg veins have one-way valves that push blood upward to your heart. When those valves fail, blood flows backward and pools in your lower legs.
The Paradox:
You have TOO MUCH blood in your lower leg (that's why it swells), but the tissue is getting TOO LITTLE oxygen (because blood is stagnant, not circulating). Your wound can't heal because tissue is suffocating despite being flooded with blood.
Venous ulcers don't appear overnight. You probably ignored warning signs for months or years before the wound opened:
Legs swell by end of day. Shoes get tight. Legs feel heavy, achy, tired. Symptoms improve overnight when elevated. You think it's age, weight, or standing too much.
This was your window to prevent the ulcer. Compression stockings started here would have prevented everything that followed.
Brown/rust-colored staining around ankles (hemosiderin from leaked blood cells). Skin becomes dry, itchy, inflamed. Eczema-like patches. Skin thickens and hardens (lipodermatosclerosis).
Your primary care doctor might have mentioned "venous stasis" but didn't emphasize urgency. You didn't realize your leg was approaching the point of no return.
Minor trauma—bumped into furniture, sock rubbed wrong spot, bug bite—breaks the fragile, oxygen-starved skin. And it doesn't heal. Normal wound healing requires good blood circulation. Your leg doesn't have that anymore.
Without addressing the mechanical problem (blood pooling), the wound will stay open indefinitely. Fancy dressings won't fix broken leg veins.
Since your natural valves failed, compression stockings/wraps become your artificial valves. They physically squeeze your leg veins, forcing blood upward and preventing pooling. Without this external pressure, blood will continue pooling and your wound will never close.
Let's address the elephant in the room: Even after your ulcer heals, you'll need compression stockings every single day for the rest of your life.
Take them off permanently? Your ulcer will return within weeks to months. The valve damage is permanent. Compression is your new reality forever.
Why Patients Fail:
The Honest Conversation:
If you're not willing to commit to daily compression forever, we can still treat your wound—but you need realistic expectations. We can close the ulcer temporarily, manage pain, and reduce infection risk. But it will likely reopen eventually.
Some elderly/hospice patients choose comfort care over aggressive compression. That's a valid choice when quality of life matters more than wound closure.
How to know your leg wound is venous (not arterial, diabetic, or infectious):
Important: We always check ankle-brachial index (ABI) to rule out arterial disease before applying compression. Compression on arterial wounds can cause amputation. If you have BOTH venous and arterial disease, treatment is much more complex.
We come to your home/facility with a clear priority order. Everything serves the goal of achieving and maintaining compression compliance.
Multi-layer compression wraps (Unna boot or 4-layer system) or high-compression stockings (30-40mmHg). We assess for arterial disease first, ensure proper fit, and teach you/caregivers proper application. If you won't/can't do compression, we discuss realistic expectations upfront.
We'll help you find solutions to compliance barriers: donning devices, velcro wraps for weak hands, zippered stockings, caregiver training.
Venous ulcers produce heavy drainage (exudate). We use absorptive dressings—foams, alginates, superabsorbers—that handle the volume while maintaining moist wound environment. Prevent maceration of surrounding skin.
For ulcers that plateau despite compression, we apply cellular tissue products (amniotic membrane, bioengineered skin substitutes). These provide growth factors that kickstart stalled healing. But only work if compression continues.
Medicare covers these after conservative treatment attempted. 70-80% closure rate when combined with compression.
Remove yellow slough/non-viable tissue to expose healthy wound bed. Venous ulcers require gentler debridement than diabetic ulcers—skin is fragile. Usually enzymatic or sharp conservative debridement.
Chronic venous ulcers often colonized with bacteria. We distinguish colonization from true infection requiring antibiotics. Use antimicrobial dressings (silver, iodine) when indicated.
Weeks 1-2: Drainage decreases, swelling improves, pain reduces. Wound may look worse initially as slough removed.
Weeks 2-8: Wound begins contracting. Healthy granulation tissue (pink, beefy red) fills wound bed. Edges start closing inward.
Months 2-6: Progressive closure. Small ulcers (<5cm²) heal fastest. Large, chronic ulcers may need cellular grafts at this stage.
After Closure: Fragile new skin for 6-12 months. Compression essential to prevent immediate recurrence. Lifelong compression prevents future ulcers.
Medicare Part B covers mobile wound visits, compression therapy supplies, advanced dressings, debridement, cellular grafts, and compression stockings (4 pairs per year after ulcer heals).
Home patients: Medicare pays 80%, Medigap covers 20% (you pay $0). Full coverage details.
We'll be honest about what it takes. If you're willing to do the work (daily compression), we have an 80% healing rate. If not, we'll discuss realistic comfort care goals.
✓ Home/Facility Visits • ✓ Medicare Covered • ✓ Honest Expectations