BMJ  2006;332:347-350 (11 February), doi:10.1136/bmj.332.7537.347

Practice

ABC of wound healing

Venous and arterial leg ulcers

Joseph E Grey, Keith G Harding

Stuart Enoch

research fellow of the Royal College of Surgeons of England and is based at the Wound Healing Research Unit, Cardiff University

The first 150 words of the full text of this article appear below.

Venous leg ulceration is due to sustained venous hypertension, which results from chronic venous insufficiency. In the normal venous system, pressure decreases with exercise as a result of the action of the calf muscle pump. When the muscles relax, the valves in the perforating veins connecting the superficial to the deep venous circulation prevent reflux and the pressure remains low. The venous pressure remains high, however, in a system where the valves are incompetent.


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  		Risk factors for venous ulceration

 

Up to 10% of the population in Europe and North America has valvular incompetence, with 0.2% developing venous ulceration. Forty to fifty per cent of venous ulcers are due to superficial venous insufficiency and/or perforating vein incompetence alone with a normal deep venous system.

There are many risk factors for venous ulceration. Recurrent venous ulceration occurs in up to 70% of those at risk. Many venous ulcers are painful, so appropriate . . . [Full text of this article]


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