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Determining venous incompetence: a report from a specialised leg ulcer clinic
1Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden. mats.bjellerup@helsingborgslasarett.se
Objective:
To analyse the diagnosis, treatment and prognosis in patients attending a specialised leg ulcer clinic at a dermatology department.
Method:
In total, 345 patients were investigated and 332 registered and followed up prospectively. All patients had their arterial and venous circulation assessed with a hand-held Doppler ultrasound.
Results:
The most frequent diagnosis was venous ulceration (153 patients, 46%) followed by hydrostatic ulceration (70 patients, 21%). Venous incompetence was classified as isolated superficial (n=86) or deep venous incompetence (n=57) in 143 out of the 153 patients. Previous deep vein thrombosis (DVT) was more frequent in patients with deep venous incompetence. Of patients with venous ulcers, 38 (25%) healed within 92 days, 77 (50%) within 155 days and 115 (75%) within 329 days. Healing time was influenced by patient age, ulcer duration and ulcer area, but not by type of venous incompetence or ankle brachial pressure index. After healing, 19% of venous patients (28/144), dominated by those with superficial disease, were subject to venous vascular surgery.
Conclusion:
Classification of venous insufficiency should be mandatory in patients with venous ulcers since it determines suitability for venous surgery.
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