VENOUS DISEASE - HOW TO HEAL AND PREVENT CHRONIC LEG ULCERS

Venous disease accounts for up to 90% of all cases of chronic leg ulce rs. Patients with venous disease have relatively unhealthy, ischemic t issue in the lower legs, and slight trauma often initiates an ulcer. S ymptoms include leg swelling, which is often unilateral and persistent , and a dull ache that worsens with standing, walking, or sitting with the legs down. Approximately 50% of patients have a history of deep v ein thrombosis. A careful history and examination can rule out other c auses and guide appropriate therapy as well as prophylaxis against pro gressive disease. Elevation, compression, occlusion, and debridement a re the mainstays of treatment. Ulcer healing is gradual, often requiri ng weeks to months of therapy. Preventing recurrence requires careful attention to compression; surgery nay be indicated.