Chronic venous insufficiency and venous leg ulceration

Venous ulcers are the most common form of leg ulcers. Venous disease has a significant impact on quality of life and work productivity. In addition, t he costs associated with the long-term care of these chronic wounds are sub stantial. Although the exact pathogenic steps leading from venous hypertens ion to venous ulceration remain unclear, several hypotheses have been devel oped to explain the development of venous ulceration. A better understandin g of the current pathophysiology of vent,us ulceration has led to the devel opment of new approaches in its management. New types of wound dressings, t opical and systemic therapeutic agents, surgical modalities, bioengineered tissue, matrix materials, and growth factors are all novel therapeutic opti ons that may be used in addition to the "gold standard," compression therap y, for venous ulcers. This review discusses current aspects of the epidemio logy, pathophysiology, clinical presentation, diagnostic assessment, and cu rrent therapeutic options for chronic venous insufficiency and venous ulcer ation.