VENOUS INSUFFICIENCY LEG ULCER
Essentials of Diagnosis
•
History of venous insufficiency like
thrombophlebitis.
•
There may be immobility of calf muscles as in paraplegia.
•
There will be irregular ulceration often on
medical aspects of lower leg above medial malleolus.
•
Oedema and hyperpigmentation.
•
Skin breaks down and eventually sclerosis of
skin takes place.
Treatment
o
Compression stockings reduce oedema.
o
Compression should achieve a pressure of 50 mm
Hg below knee and 40 mmHg at the ankle.
o
Ulcer is treated with metronidazole gel to
reduce bacterial growth and odour.
o
Red dermatitis skin is treated with
corticosteroid ointment.
o
Ulcer is then covered with an exclusive hydro
active dressing.
o
Complete healing of ulcer may take 4-6 months.
o
Some ulcers may require grafting.
o
Cultured epidermal cell grafts are very useful
although costlier.
o
Ciprofloxacin 500 mg twice daily is useful.
o
Zinc supplementation is beneficial.
