- skin biology
- signs and symptoms
- investigations
- conditions and diseases
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Venous Ulcers
- epidemiology
- signs and symptoms
- diagnosis
- pathophysiology
- causes and risk factors
- treatments
- course
- patient education
- community resources
- references
Epidemiology
Almost a third of adults have venous disease.
Venous stasis ulcers affect 1% of the population, with 50% of people have an ulcer history of 10 or more years.
Signs and Symptoms
- Pitting edema
- hyperpigmentation or hypopigmentation
- tissue sclerosis
- ulceration, due to relative anoxia
ulcers tend to be irregularly shaped, with well defined borders. They are typically near the malleolus. Venous stasis ulcers never ulcerate to the tendon.
Diagnosis
Ankle brachial index (ABI)
Pathophysiology
The superficial venous system is lower pressure than that of deeper veins, to which they are connected by communicating veins.
Problems with venous valves, usually due to damage by thrombosis or infection, can lead to a rise in venous hypertension. Tissue edema can result in relative anoxia.
This may be due to increased deposition of fibrin around vessels as a pericapillary cuff, leading to decreased nutrient diffusion.
Causes and Risk Factors
Venous disease is the most common cause of venous ulcers.
Risk factors include:
- age
- obesity
- previous history of leg trauma or phlebitis
- multiple pregnancies
- prolonged sitting or standing
Treatments
Treat the ulcer with TIM:
- tissue debridement
- infection and inflammation control
- moisture balance
treat the leg with compression therapy is ABI is sufficiently high.
Course
Patient Education
Community Resources