Venous Ulcer

• What are venous ulcers primarily caused by?


  Long-standing venous hypertension leading to venous valve incompetence
• Where do venous ulcers typically present on the body?


  Primarily over the medial malleolus
• What are common accompanying symptoms of venous ulcers?


  Oedema, skin thickening, and eczema
• What are key risk factors for developing venous ulcers?


  Obesity, immobility, varicose veins, previous DVTs, age, and prior trauma to the leg
• What are the management strategies for venous ulcers?


  • Lifestyle advice
  • Emollient treatment
  • Compression bandaging
  • Medication (e.g., Pentoxifylline)
  • Surgery (rarely necessary)
• What complications can arise from venous ulcers?


  Decreased mobility, increased risk of infection, osteomyelitis, and decreased quality of life
• What is the definition of venous ulcers?


  Skin ulcers predominantly caused by sustained venous hypertension
• What is the estimated prevalence of venous leg ulcers in the UK?


  0.1% to 0.3%
• What are the distinctive features of venous ulcers?


  • Predominantly found over the medial malleolus
  • Shallow and sloughy in nature
  • Presence of haemosiderin deposition
  • Oedema
  • Skin thickening
  • Eczema
• What are the differential diagnoses for venous ulcers?


  Arterial ulcers and neuropathic ulcers
• How do arterial ulcers differ from venous ulcers?


  Arterial ulcers are typically found on the lateral malleolus or toes and are often painful
• What is the primary investigation for managing venous ulcers?

  The Ankle-Brachial Pressure Index (ABPI)
• Why is the ABPI conducted in the management of venous ulcers?


  To rule out co-existing arterial disease that might worsen with compression bandaging
• What lifestyle advice is recommended for managing venous ulcers?


  • Maintain cleanliness of the ulcer
  • Promote mobility
  • Suggest weight reduction
  • Recommend leg elevation at rest
• What is the purpose of compression bandaging in venous ulcer management?


  To improve venous return from the leg
• When might medication like Pentoxifylline be considered in venous ulcer treatment?


  If the ulcer fails to respond to initial treatment
• What surgical options are available for venous ulcers?


  Debridement and skin grafting
• What are the potential complications of venous ulcers?


  • Decreased mobility due to pain
  • Risk of infection, which can progress to sepsis
  • Possibility of osteomyelitis
  • Decreased quality of life due to persistent pain and disability