Venous Ulcers

WoundSource Editors's picture
venous system

A venous ulcer, also known as a stasis ulcer or venous leg ulcer, is a shallow wound that usually occurs on the sides of the lower leg, between the calf and ankle. Since venous ulcers often are slow in healing and frequently recur if not properly treated, it is important for health care providers to understand their diagnosis and treatment.

Temple University School of Podiatric Medicine's picture
wound care journal club

Venous leg ulcers (VLUs) affect 3% of all people aged 65 years and older. After healing, the recurrence rate can be as high as 69%, making the treatment of VLUs costly to the healthcare system. In Australia alone, VLUs cost the healthcare system $400-500 million per year. VLUs are problematic for patients beyond the physical ulceration of their feet because they create social and psychological challenges. Therefore, treating a VLU entails not only closing the ulcer with full epithelialization, but also taking the correct measures to prevent its recurrence.

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Temple University School of Podiatric Medicine's picture
wound care journal club

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Temple University School of Podiatric Medicine's picture
Journal Club Review

Temple University School of Podiatric Medicine Journal Review Club

Article title: Treatment with LL-37 is safe and effective in enhancing healing of hard-to-heal venous leg ulcers: a randomized placebo controlled clinical trial.
Authors: Alvar Gronberg, DrMedSc; Margit Mahlapuu, PhD; Mona Stahle, MD, PhD; Caroine Whately-Smith, CStat; Ola Rollman, MD, PhD.
Journal name and issue: Wound Repair and Regeneration, September-October 2014 (pages 613-621).
Reviewed by: Lucy Barrow, Temple University School of Podiatric Medicine

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Bruce Ruben's picture
hand wound

by Bruce E. Ruben MD

A non-healing wound is generally defined as a wound that will not heal within four weeks. If a wound does not heal within this usual time period, the cause is usually found in underlying conditions that have either gone unnoticed or untreated. In general, there are five reasons why wounds will not heal and more than one of these conditions can be operating at the same time.

Laurie Swezey's picture
superficial venous insufficiency ulcer

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Lower extremity venous insufficiency ulcers represent approximately 80% of the leg ulcers typically seen in wound care facilities. The following statistics help to bring home the seriousness and chronicity of this common health problem:

  • Healing time for venous insufficiency ulcers averages 24 weeks
  • Approximately 15% of these ulcers will never heal
  • In 15 to 71% of cases of venous insufficiency ulcers, the ulcers represent a recurrent lesion
  • It is estimated that the cost of treating venous insufficiency ulcers is 1 to 5 billion dollars every year
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Michel Hermans's picture
healing rate

by Michel H.E. Hermans, MD

An interesting article in JAMA Internal Medicine (February 2015) by doctors from Massachusetts, Maryland and California (A.B. Jena, M.D. lead author) analyzed mortality and treatment differences in patients who were admitted with cardiovascular pathology during dates of national cardiology meetings and compared these with the situation when the physicians were at the hospital. They found that high-risk patients with heart failure and cardiac arrest had a lower 30-day mortality rate when a national cardiology meeting was taking place.

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Bruce Ruben's picture

by Bruce E. Ruben MD

Chronic venous insufficiency (CVI) refers to a long-term condition where the veins inside the legs have lost their ability to move blood back up to the heart from the legs. This occurs because the vein walls have weakened to the point where the venous pumps are no longer sufficient enough to send blood back up, against gravity, to the heart. CVI also affects the tiny valves inside the leg veins. When these valves do not close sufficiently, blood seeps back down past the valves and pools in the lower legs.

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Temple University School of Podiatric Medicine's picture

by Carmelita Harbeson and James McGuire DPM, PT, CPed, FAPWHc

Compression therapies work to restore circulation, reduce edema, and enhance tissue stability. With the myriad of compression options available, sorting through which treatments are best for each patient can be a daunting task for clinicians. This post presents an introduction to Tubigrip™, a multi-purpose tubular compression bandage and focuses on its utilization in decreasing edema associated with venous and lymphatic conditions.

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Michel Hermans's picture

Part 2 in a series on clinical trials in wound care
For part 1,
click here.
by Michel H.E. Hermans, MD

In the first part of this series on the challenges of conducting clinical trials in wound care, I discussed factors that include patient populations and lesion prevalence. Additional criteria and conditions of the clinical trial will be further examined in this blog.

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