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Venous ulcers are costly to treat, and there is a significant chance that they will recur after healing; [3] [10] one study found that up to 48% of venous ulcers had recurred by the fifth year after healing. [10] However treatment with local anaesthetic endovenous techniques suggests a reduction of this high recurrence rate is possible. [48]
Ankle flares are often caused by venous ulcer, due to deep vein thrombosis or varicose veins. It is considered to be an early sign of advanced venous disease. [1] Treatment involves management of the underlying condition, along with supportive care.
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Treatment options for PTS include proper leg elevation, compression therapy with elastic stockings, or electrostimulation devices, pharmacotherapy (pentoxifylline), herbal remedies (such as horse chestnut, rutosides), and wound care for leg ulcers. [1] [21] The benefits of compression bandages is unclear. They may be useful to treat edemas. [7]
Venous ulcers are common and very difficult to treat. Chronic venous ulcers are painful and debilitating. Even with treatment, recurrences are common if venous hypertension persists. Nearly 60% develop phlebitis which often progresses to deep vein thrombosis in more than 50% of patients. The venous insufficiency can also lead to severe hemorrhage.
They also aid in the treatment of ulcers of the lower legs. Unlike traditional dress or athletic stockings and socks, compression stockings use stronger elastics to create significant pressure on the legs, ankles and feet. Compression stockings are tightest at the ankles and gradually become less constrictive toward the knees and thighs.
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Some risk factors for developing diabetic foot infections include history of repeated foot ulcers, foot ulcers lasting for longer than 30 days, poor control over blood glucose levels, peripheral neuropathy, renal impairment, peripheral artery disease, injury or trauma to foot, walking barefoot frequently, and history of amputation in lower limbs.
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