Venous leg ulcers

Investigation of the patient with a venous ulcer

“…The two most common causes after venous disease are arterial insufficiency and neuropathic ulcers. 7 Risk factors associated with development of venous insufficiency include height, obesity, age, gender, race, work, diet, geographical location, social class, lifestyle, contraceptive pills, hormone replacement therapy, pregnancy and family history. Family history and female gender have shown the strongest correlation.…”

“…8 Symptoms worsen at the end of the day after long periods of standing and improve with leg elevation. 7…”

“…21 In patients with intact sensation, normal distal pulses and an ABPI ≥ 0.9, the likelihood that an ulcer is venous is more than 90%. 7…”

“…Duplex ultrasound (DU) is the diagnostic investigation of choice for evaluating lower limb venous disease. 7 DU is considered an essential investigation in patients with complications arising from CVI, especially venous ulceration. DU is the most useful test for detecting, localizing and evaluating chronic venous obstruction and venous valvular incompetence.…”

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“…DM is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation [3]. DM related ulcers rank first among lower extremity ulcers, which in most cases result to sensitivity loss [4]. Diabetic neuro-and angiopathy are major factors causing diabetic foot ulcers (DFU) [5], resulting from ischemic reduction of oxygen and nutrients supply to the ulcerous site, thus hindering the optimal wound healing process in such patient cohorts.…”