Venous ulcers (venous insufficiency ulceration, stasis ulcers, stasis dermatitis, varicose ulcers, or ulcus cruris) are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs (hence leg ulcers). They are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. Venous ulcers develop mostly along the medial distal leg, and can be very painful. Edema and fibrinous exudate leads to fibrosis of subcutaneous tissues with localized pigment loss and dilation of capillary loops. This is called atrophic blanche. This can occur around ankles and gives an appearance of inverted champagne bottle to legs. Large ulcers may encircle the leg. Lymphedema results from obliteration of superficial lymphatics. There is hypertrophy of overlying epidermis giving polypoid appearance, known as lipodermatosclerosis
HOW IS VENOUS ULCER DIAGNOSED?
A clinical severity score has been developed to assess chronic venous ulcers. It is based on the CEAP (clinical, etiology, anatomy, and pathophysiology) classification system developed by an expert panel. This is done by a general surgeon.
HOW IS VENOUS ULCER TREATED?
Treatment options for venous ulcers include conservative management, mechanical treatment, medications, and surgical options (Table 2).1,2,7,10,19,22–44 In general, the goals of treatment are to reduce edema, improve ulcer healing, and prevent recurrence. Although numerous treatment methods are available, they have variable effectiveness and limited data to support their use.
DID YOU KNOW?
Venous Ulcers develop mostly along the medial distal leg and are very painful.