
An overview of the relationship between anaemia, iron, and venous leg ulcers
Author(s) -
Ferris Amy E.,
Harding Keith G.
Publication year - 2019
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.13192
Subject(s) - medicine , iron deficiency , wound healing , context (archaeology) , venous leg ulcer , hypoxia (environmental) , tissue hypoxia , ferritin , disease , intensive care medicine , surgery , anemia , pathology , erythropoietin , oxygen , paleontology , chemistry , organic chemistry , biology
The factors preventing healing in venous leg ulcers are still not fully understood. Iron‐mediated tissue damage has been hypothesised, yet anecdotally anaemia is also thought to have a negative effect on wound healing. This article summarises the current evidence for these theories and their likely effects in the context of venous ulceration. A comprehensive search of the literature was conducted. Studies suggest that a number of forms of iron including haemosiderin and ferritin are implicated in progression of venous disease, ulcer formation, and impaired healing, which is thought to be primarily free radical mediated. There is a paucity of evidence for the role of iron deficiency and anaemia on ulcer healing; however, there is likely to be a highly complex interplay between the damaging effects of iron on local tissues and the negative effects of anaemia‐mediated tissue hypoxia. Studies looking at options to increase local oxygen delivery such as topical haemoglobin suggest that this may have an impact on some aspects of healing, but findings are generally inconclusive. There is growing evidence that locally elevated iron levels may have a detrimental effect on ulcer healing and formation; however, more robust research is needed.