IntroductionVenous leg ulcers (VLUs) represent a major chronic wound condition associated with high recurrence rates, prolonged healing, and substantial socioeconomic burden. Hydrogels have recently gained attention as effective wound dressings due to their moisture-retentive and biocompatible properties. This study aimed to evaluate the clinical effectiveness of a combined therapy using octenidine gel and a hydrogel dressing compared to a silver-containing calcium alginate dressing in patients with VLUs.MethodsA randomized controlled trial was conducted, enrolling 60 patients with chronic VLUs. Participants were randomly assigned to either an experimental group (octenidine gel + hydrogel dressing) or a control group (silver-containing calcium alginate dressing). Wound healing progress was assessed using the RESVECH 2.0 Scoring Scale, which evaluates six wound parameters of effective wound healing. Measurements were taken at baseline and after 4 weeks of treatment.ResultsAfter 4 weeks, the experimental group showed statistically significant improvements in wound size, wound edges, tissue in the wound bed, exudate, infection/inflammation signs, and overall RESVECH 2.0 total score. No significant changes were observed in the control group. Between-group comparisons confirmed superior healing outcomes in the experimental group.DiscussionThe combination of octenidine gel and a hydrogel dressing significantly enhanced healing outcomes in patients with VLUs compared to conventional silver-containing dressings, suggesting that hydrogel-based antiseptic therapy is an effective alternative for VLU management. Given the chronic nature and high recurrence rates of VLUs, incorporating hydrogel-based antiseptic dressings into standard treatment protocols may improve patient outcomes and reduce healing time.