SINGLE-VISIT VENOUS ULCER ASSESSMENT CLINIC - THE FIRST YEAR

Background Venous ulceration is a significant clinical problem to both clinicians and patients. To optimize the management of patients with ulcers a single-visit, dedicated venous ulcer assessment clinic was se t up. Methods All patients referred to the clinic during the first yea r were recorded prospectively, Each patient was assessed clinically an d with colour-coded venous and, where indicated, arterial duplex scann ing. Ulcers were classified as venous, arterial, mixed or non-vascular on a basis of ankle:brachial pressure indices and venous duplex scann ing. Results Eighty-eight patients (104 limbs with ulcers) were assess ed. Seventy-nine per cent of ulcers were venous, 2 per cent arterial, 12 per cent mixed and 7 per cent non-vascular. Of the 95 limbs with de monstrable venous reflux, reflux was confined to the superficial syste m in 57 per cent, the deep system in 6 per cent and was combined in 37 per cent of limbs. Of the 22 patients who reported previous deep vein thrombosis, nine had normal deep vein function. Some 38 per cent of l imbs with no history of previous thrombosis had abnormal deep vein fun ction. Conclusion In this clinic 14 per cent of leg ulcers had a signi ficant arterial component and over half of venous ulcers may benefit f rom superficial venous surgery. In many ulcerated limbs, clinical asse ssment alone is inadequate to detect superficial reflux or previous de ep vein thrombosis.