Identifying Venous Leg Ulcers

Venous leg ulcers can be caused by chronic venous insufficiency (CVI)1.  This can be caused by reflux in any of the venous systems – whether superficialperforator, or deep – when the valves of the veins have failed or the vein has become obstructed2.  2014 SVS/AVF venous leg ulcer guidelines recommend comprehensive venous duplex ultrasound examination of the lower extremity in all patients with a suspected venous leg ulcer, in order to identify the cause3.

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 STEP 1: DIFFERENTIATE ARTERIAL ULCER FROM VENOUS ULCER

Ulcer appearance together with the medical history and physical exam should be used to determine the different diagnosis and see if a venous leg ulcer is suspected.

STEP 2: TEST FOR CHRONIC VENOUS INSUFFICIENCY (CVI)

Comprehensive Venous Duplex Ultrasound Examination of the lower extremity should be performed in all patients with a suspected venous leg ulcer in order to identify the cause.  The Society of Vascular Surgery (SVS) and the American Venous Forum (AVF) 2014 venous leg ulcer guidelines provide a strong recommendation for conducting this exam.

STEP 3: IDENTIFY THE UNDERLYING CAUSE

Venous leg ulcers can be caused by chronic venous insufficiency (CVI)1, a more serious form of venous reflux disease which can cause reflux in any of the venous systems – superficialperforatoror deep.  Ultrasound testing will help define the underlying cause of this disease and help in determining the right treatment for patients.

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