The venous ulcer continues to be a clinical challenge: an update

Abstract

Venous ulcers are a common chronic problem in many countries especially in Northern Europe and USA. The overall prevalence of this condition is 1% rising to 3% in the over 65 years of age. Over the last 25 years, there have been many developments applicable to its diagnosis and treatment. These advances, notwithstanding healing response and recurrence, are variable, and the venous ulcer continues to be a clinical challenge.The pathogenesis of venous ulcers is unrelieved or ambulatory venous hypertension resulting mostly from deep venous thrombosis leading to venous incompetence, lipodermatosclerosis, leucocyte plugging of the capillaries, tissue hypoxia and microvascular dysfunction. It is not known what initiates venous ulcers. Triggers vary from trauma of the lower extremity to scratching to relieve itchy skin over the ankle region. Venous ulcers can be painful, and this condition presents an increasing burden of care. A systematic analysis of the role of technology used for diagnosis and management strongly supports the use of compression as a mainstay of standardised care. It further shows good evidence for the potential of some treatment procedures to accelerate healing. This article reviews the pathogenetic mechanisms, current diagnostic methods and standard care and its limitations.

Human Wounds and Its Burden: An Updated Compendium of Estimates

“…37 In the United States and Europe, people >65 years of age are vulnerable to venous ulcers. 38 The prevalence of venous ulcers is 1% of the population globally among those aged 18-64. 39 In the United States, 10-35% of the population suffer from some kind of chronic venous issues with 4% (>65 age group) of the cases having active ulcers.…”

Use of the Nursing Outcomes Classification - NOC to assess the knowledge of patients with venous ulcer

“…An integrative review sought to find evidences related to the standard VU treatment and CVI control, finding, as its results, the use of adequate lower-limb compression techniques and the search for adjunct materials to accelerate the scarring process (3) . The knowledge of professionals regarding the best evidence-based practices leads to quality assistance and provides satisfaction to the patient and to the healthcare team.…”

“…The worldwide prevalence of UVs is from 1% to 3% in the population over 65 years of age, with a strong social and economic impact. The treatment consists in the control of venous hypertension through the use of compressive therapy, the strengthening of lower-limb muscles, and walking and resting in alternate turns (3)(4) . In addition, the treatment includes topical care to the wounds using different types of dressing, according to the tissues in evidence.…”

“…In addition, the treatment includes topical care to the wounds using different types of dressing, according to the tissues in evidence. Healthy lifestyles and the control of other comorbidities influence in the therapeutic success and in the prevention of complications (3)(4)(5) . Adjunct therapies are also used to fasten the scarring process, and low-level laser therapy (LLLT ) is strongly recommended (6)(7) .…”

Successful Treatment of Multiple Chronic Leg Wounds - a Case Report

“…The management of vascular leg ulcers puts a considerable burden on a patient and the health care system. Moreover, these non-healing ulcers increase the risk for lower extremity amputation [3].…”