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A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
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.
Compression stockings are elastic compression garments worn around the leg, compressing the limb. This reduces the diameter of distended veins and increases venous blood flow velocity and valve effectiveness. Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching ...
The National Institute for Health and Clinical Excellence (NICE) produced clinical guidelines in July 2013 recommending that all people with symptomatic varicose veins (C2S) and worse should be referred to a vascular service for treatment. [33] Conservative treatments such as support stockings should not be used unless treatment was not possible.
Randomised controlled trials into the use of ESWT for healing venous leg ulcers are needed as there is a lack of evidence in this area. [22] Low-intensity extracorporeal shock wave therapy has been used as a treatment for erectile dysfunction. [23]
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.
An interesting off-label indication of pentoxifylline is the supportive treatment of distal diabetic neuropathy, where it can be added, for example, to thioctic acid or gabapentin. [17] Theoretically, it can (among other things) act prophylactically against ulcerative changes of the lower limbs associated with chronically decompensated diabetes.
Causes [2] of venous stasis include: Obesity; Pregnancy; Previous damage to leg; Blood clot; Smoking; Swelling and inflammation of a vein close to the skin; Congestive heart failure. [3] Long periods of immobility that can be encountered from driving, [4] flying, bed rest/hospitalization, or having an orthopedic cast.
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