What's new: Management of venous leg ulcers: Approach to venous leg ulcers

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• 作者：Afsaneh Alavi ; MD^a ; ^{afsaneh.alavi@utoronto.ca" class="auth_mail" title="E-mail the corresponding author} ; R. Gary Sibbald ; MD^a ; ^b ; Tania J. Phillips ; MD^c ; O. Fred Miller ; MD^d ; David J. Margolis ; MD ; PhD^e ; William Marston ; MD^f ; Kevin Woo ; RN ; PhD^g ; Marco Romanelli ; MD ; PhD^h ; Robert S. Kirsner ; MD ; PhDⁱ
• 关键词：leg ulcers ; lipodermatosclerosis ; venous disease ; venous leg ulcers ; wound healing
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：74
• 期：4
• 页码：627-640
• 全文大小：1881 K

文摘

Leg ulcerations are a common problem, with an estimated prevalence of 1% to 2% in the adult population. Venous leg ulcers are primarily treated in outpatient settings and often are managed by dermatologists. Recent advances in the diagnosis and treatment of leg ulcers combined with available evidence-based data will provide an update on this topic. A systematized approach and the judicious use of expensive advanced therapeutics are critical. Specialized arterial and venous studies are most commonly noninvasive. The ankle brachial pressure index can be performed with a handheld Doppler unit at the bedside by most clinicians. The vascular laboratory results and duplex Doppler findings are used to identify segmental defects and potential operative candidates. Studies of the venous system can also predict a subset of patients who may benefit from surgery. Successful leg ulcer management requires an interdisciplinary team to make the correct diagnosis, assess the vascular supply, and identify other modifiable factors to optimize healing. The aim of this continuing medical education article is to provide an update on the management of venous leg ulcers. Part I is focused on the approach to venous ulcer diagnostic testing.