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Venous leg ulcers (VLUs) are the most common type of chronic lower limb ulcer, accounting for 60–80% of all leg ulcers. They are a direct complication of Chronic venous insufficiency (CVI) , resulting from sustained venous hypertension, most often due to valvular incompetence, venous obstruction, or both.
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Understanding Leg and Foot Ulcers
Cartoon of the pathophysiology of venous leg ulcers (VLUs). a The effects of valve incompetence and b the effects on tissues that lead to lipodermatosclerosis, cell death and ulceration. (Figures a and b were reprinted with permission from Mani R. Chronic Wound Management—the Evidence for Change, Parthenon Press 2002; copyright 2002 by Mani)
| Feature | Details |
|---|---|
| Pain | Usually mild, may increase with infection |
| Appearance | Irregular, shallow ulcers with granulation tissue and exudate |
| Surrounding skin | Hyperpigmentation (hemosiderin), lipodermatosclerosis, varicosities |
| Edema | Pitting edema often present |
| Discharge | Common; may be copious and foul-smelling if infected |
a Typical appearance of patient with lipodermatosclerosis. The skin is flaky and there is a brownish discoloration. The skin can have a waxy feel to it. b A venous ulcer on the medial aspect of the leg
Xie, T., Ye, J., Rerkasem, K. et al. The venous ulcer continues to be a clinical challenge: an update. Burn Trauma 6, 18 (2018). https://doi.org/10.1186/s41038-018-0119-y