Leg ulcers: Epidemiology and aetiology

Abstract

In a regional Health District with a population of 198,900, 357 patients with 424 ulcerated legs were documented, an overall prevalence of 0.18 per cent. The prevalence of ulceration in the 92,100 aged greater than 40 years was 0.38 per cent. Fifty per cent of the lesions had been present for more than one year, and 62 per cent of patients had never attended any hospital. The patients were stratified by history of peripheral arterial disease. A random sample (100 patients, 193 legs) was examined by ultrasound and photoplethysmography to assess the venous and arterial circulation; 38 per cent had evidence of deep vein involvement and 43 per cent had superficial vein incompetence. An ischaemic element was present either in isolation (9 per cent) or combined with venous disease (22 per cent) in a total of 31 per cent, with a mean pressure index of 0.62 (s.d. 0.14). Simple objective methods of assessment together with dedicated community staff with ready access to specialized facilities can enhance the service provided to patients with leg ulcers.

Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis

“…An important finding was that most of these cases became clinically manifest within the first 2 years of the acute thrombotic event, which contrasts with the general belief that it takes 5-10 years for the syndrome to become evident. 1,2 The use of a sized-to-fit graded compression stocking, applied within 2-3 weeks of the initial diagnosis, reduced the rate of mild-to-moderate and severe post-thrombotic syndrome by about 50%. Furthermore, most patients in the stocking group who developed post-thrombotic syndrome did so within the first 30 months.…”

Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial

“…In the current study, 16 wk of EVS use preserved skin barrier function as measured by TEWL. Since vascular insufficiency is known to contribute to lower-limb ulceration [28], that EVS improves perfusion and preserves skin barrier function may be physiologically aligned.…”

Systematic review of topic treatment for venous ulcers

“…presented signs of ischemia and only 10% did not show signs of arterial or venous insufficiency (4) .…”