Horse-chestnut (Aesculus hippocastanum) seed extract for venous leg ulceration: a comparative multiple case study of healers and non-healers

Background Venous leg ulceration (VLU) is a chronic and recurrent condition that affects around 0.12–1.1% of the Western population. One intervention that is showing promise as a treatment for VLU is horse-chestnut (Aesculus hippocastanum) seed extract (HCSE), with evidence suggesting that HCSE treatment may reduce wound slough, the frequency of dressing changes and the overall cost of VLU management. However, it remains unclear as to the types of patients that HCSE is likely to benefit. Objective To illustrate the types of patients that may benefit from the use of HCSE for the treatment of VLU, and the typical response patterns that may be observed. Methods Comparative multiple-case study of VLU healers and non-healers treated with HCSE. Results When comparing the HCSE-healed cases with the HCSE non-healed cases, what emerges is that HCSE treatment may be most effective when the following elements are present: mild to moderate venous insufficiency, a small wound of short duration, a short history of ulceration, and no signs of wound infection. Conclusions A number of variables were identified as having an influence on the trajectory of venous ulcer healing among patients treated with HCSE. Further investigation is needed to validate these findings.