Chronic ulceration of the leg

Publication date: Available online 17 January 2019Source: Surgery (Oxford)Author(s): Manj GohelAbstractThe management of patients with chronic leg ulcers represents an enormous burden to healthcare services in the United Kingdom. Most leg ulcers are due to chronic venous hypertension, although arterial compromise, malignancy, vasculitis and other medical disorders are also recognized causes. The assessment of patients with chronic leg ulceration should include a detailed history and clinical examination, supported by relevant investigations. Ankle-brachial pressure index measurement and non-invasive venous (± arterial) imaging using colour duplex are the principal investigations. The mainstay of treatment for patients with chronic venous ulceration is compression therapy, applied by trained clinical teams bridging primary and secondary care settings. Prompt endovenous ablation of superficial venous reflux accelerates ulcer venous healing and may have an important role in reducing ulcer recurrence. Patients with arterial compromise may require endovascular or surgical revascularization to promote healing. The causes, assessment and management of patients with chronic leg ulceration are discussed in this article.
Source: Surgery (Oxford) - Category: Surgery Source Type: research