Diagnosis and Treatment of Venous Leg Ulcer

Abstract

Venous leg ulcer (VLU) represent a pathological tissue change in the form of a defect in the lower leg which occurs as a complication of chronic venous insufficiency. The prevalence of VLUs varies between 1.5–3% in the total population and 4–5% in persons over the age of 80. Venous ulcer is usually localized on the inner side of the lower third of the leg, oval, circular or irregular in shape. It is usually fibrous or covered with fresh granules that bleed heavily to the touch. It is very important to have a comprehensive clinical examination at the very beginning. Subsequent non-invasive and sometimes invasive tests may be indicated for diagnosis and treatment planning. Inadequate diagnosis results in inadequate therapy. The goal of therapy is complete restitution of the tissue defect and prevention of recurrence. The three basic elements of VLUs therapy are: local therapy, compression therapy and surgical treatment. If VLUs do not heal despite the application of standard therapeutic modalities, there are opportunities to apply new treatment technologies. The modern approach to the treatment of VLUs is based on the application of various biophysical interventions and medical devices.