Compression stockings·Ulcus Cruris Venosum

“We need more prevention and education”

Practical wound management

From Bauerfeind Life Magazin on 22.06.2023

In short Gabi Weigold, nurse, specialist wound therapist, and certified wound manager has realized the following in more than 20 years’ practical experience: many patients who are diagnosed with venous leg ulcers do not start treatment early enough. They also know very little about the consequences of their condition. The Managing Director of the “Wundmanagement Gabi Weigold” practice in Döhlau close to Hof therefore advocates:

  • better education and sharing of basic knowledge about the causes of ulcers at all levels, from healthcare providers to patients.
  • a wide range of training, information, and prevention options, just like those she has established herself in her educational institute.
  • a high level of compliance in patients who understand that, following decongestion and wound healing, medical compression stockings will be daily companions from now on.

When it comes to wound treatment, Gabi Weigold is in her element. The self-employed expert therapist appeals to healthcare professionals as well as patients to take the causes of ulcers seriously – and ideally try to prevent venous leg ulcers from developing altogether.

Gabi Weigold carefully removes the dressing from her patient’s outer lower leg. “Is this OK?” she asks. “It’s a little uncomfortable,” Margit B. replies, but that is nothing new. The two women are an established team. The 77-year-old visits Gabi Weigold’s wound management practice in Döhlau, Upper Franconia, three times a week to have her bandages changed. She has been suffering from mixed leg ulcers since 2016, meaning she has both chronic venous insufficiency (CVI) and peripheral arterial disease (PAD). This is the most common condition that Gabi Weigold, specialist wound therapist and certified wound manager, treats in her practice. “The second most common problem is ulcers without a proper diagnosis,” she says. Which brings her to her favorite subject: “We need more education in this area!” In more than 20 years of professional experience in the field of vascular disorders, she has noticed gaps in knowledge or an underestimation of venous leg ulcers – the most severe form of chronic venous insufficiency (CVI) and one of the most common causes of wounds that do not heal by themselves – from family physicians to hospital staff, from carers to patients.

Gabi Weigold looks after Margit B.’s wounds three times a week. In addition to changing the bandages, this includes foam cleaning and skin care. 

Raising awareness of the subject with training and presentations 

Gabi Weigold has been self-employed since 2008. Five years ago, she and her five-strong team moved into new practice premises on the outskirts of Döhlau close to Hof: spacious parking in front of the building, accessible entrance and a bright, inviting ambiance where patients can feel at home. Less mobile patients are cared for by Gabi Weigold’s staff in their homes, nursing homes or doctors’ practices. Gabi Weigold’s educational institution is also located in this building. This is where she provides basic training as well as recertification courses for ICW wound experts1. Presentations for patients, family members and interested laypeople are also part of the program. The managing director hopes that this will lead to more education and also an increased interest in prevention, with targeted exercise for example: her offer includes yoga, seated exercises, and Nordic walking for beginners. “We want people to get out, get moving and talk to others,” Gabi Weigold says, describing the concept. Her dream: “founding some kind of self-help group. That exists for all kinds of diagnoses, but not for patients suffering from ulcers.” 

“If you need compression stockings,
they will accompany you for the rest of your life.”

Gabi Weigold

In general, she misses a lot of services that are part of the treatment for other conditions, such as consultation sessions and training that people with diabetes receive. Or regular appointments for decongestion and circumference measurements: if no more changes in circumference can be seen in four to six weeks, compression bandages can be replaced by stockings. “If patients knew this time frame, it would really unburden and encourage them,” she thinks. 

Gabi Weigold, nurse, specialist wound therapist and certified wound manager, is the Managing Director of the Wundmanagement Gabi Weigold practice in Döhlau, Upper Franconia.

But reality is different. “A lot of people visit me and tell me that they have a deep wound on their leg, hoping there’s a dressing we can put on it,” the specialist from Upper Franconia reports. Very few people are aware of what this is really about and the lifelong consequences associated with ulcers. And that treatment should have started much earlier. But initially, most people do not take the symptoms seriously. An insect bite that was scratched, a careless bump – but why is the wound still not healing even after several weeks, despite using dressings and antibiotics?  The true cause does not come to light until later. When they finally make their way to her practice, Gabi Weigold tries to vividly illustrate the function of veins and arteries to her patients – and to make them realize that they will continue to need medical compression stockings even after the venous leg ulcers have healed. And successfully so: “most patients trust me and can be persuaded if everything is explained in detail. Many are grateful to receive instructions.” At her practice, they feel they are treated and seen as a whole person. Because a lot of the time, treatment options are chosen based on symptoms, not considering the actual root causes. 

Improved quality of life, thanks to compression stockings

Gabi Weigold is not afraid to contact physicians, and she expects professional medical retailers to remind patients in good time to get a new prescription. “Unfortunately, many patients think everything is OK when the wound has healed.” But the trigger for venous leg ulcers, CVI, cannot be healed, meaning daily compression will be part of the patient’s life from then on. That applies to younger patients who want to get back to work as quickly as possible, as much as those over 60, the latter being the majority of her patients. They will regain a great deal of independence and quality of life after the decongestion phase with the compression stocking because they can put it on themselves, usually supported by a donning aid. That applies to compression class 3 in particular, which Gabi Weigold would prefer in more cases to the usually prescribed Ccl 2. “In consultation with the physician, I like to recommend the VenoTrain ulcertec,” she explains, because the liner and overstocking worn together result in Ccl 3. Individually, they’re easier to put on than one Ccl 3 stocking, and the liner can even be worn at night. When choosing a style, too, the individual has to be considered, the wound expert emphasizes. In this spirit, she suggested to an unhappy patient suffering from incontinence that she should discuss with her physician the option of being prescribed thigh-high stockings instead of pantyhose. Everything can be tested. But Gabi Weigold is sure of one thing: “if you need compression stockings, they will accompany you for the rest of your life.” 

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Images: Bauerfeind, Frank Steinhorst

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