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The National Institute for Health and Care Excellence (NICE) recommends referral to a vascular service for anyone with a leg ulcer that has not healed within two weeks or anyone with a healed leg ulcer. [17] Most venous ulcers respond to patient education, elevation of foot, elastic compression, and evaluation (known as the Bisgaard regimen). [18]
Venous ulcers, which usually occur in the legs, account for about 70% to 90% of chronic wounds [2] and mostly affect the elderly. They are thought to be due to venous hypertension caused by improper function of valves that exist in the veins to prevent blood from flowing backward.
Cullum was made Dame Commander of the Order of the British Empire for services to nursing research and wound care in the 2013 Birthday Honours.She was an inaugural National Institute for Health Research (NIHR) Senior Investigator (2008–2012, renewed 2013) and was made a Fellow of both the Academy of Medical Sciences (FMedSci) and the American Academy of Nursing (FAAN) in 2012.
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.
Venous skin ulcers that may appear on the lower leg, above the calf or on the lower ankle usually cause achy and swollen legs. If these ulcers become infected they may develop an unpleasant odour, increased tenderness and redness. Before the ulcer establishes definitively, there may be a dark red or purple skin over the affected area as well as ...
When the valves of perforator veins become incompetent they can cause venous reflux when the muscles contract. This has been explained by Mark Whiteley as "active venous reflux". [4] The resulting reflux can cause a rapid deterioration in an existing varicose disease and be responsible for the development of venous ulcers.
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