[What should we know about venous and arterial ulcers?]

Area of Science:

• Vascular Medicine
• Dermatology
• Wound Care

Context:

• Chronic venous insufficiency (CVI) results from venous valvular incompetence or outflow obstruction, affecting superficial or deep venous systems.
• Long-term venous hypertension causes significant pathologic venous and tissue changes, leading to clinical manifestations of varying severity.
• Distinguishing between venous leg ulcers (medial malleolus, yellowish base) and arterial leg ulcers (dry, cool, hairless skin) is crucial for appropriate management.

Purpose:

• To define chronic venous insufficiency and its underlying pathophysiology.
• To describe the clinical presentation and characteristics of venous leg ulcers and arterial leg ulcers.
• To outline current therapeutic strategies for managing leg ulcers, emphasizing topical and systemic treatments.

Summary:

• Chronic venous insufficiency is characterized by abnormal venous function, leading to venous hypertension and potential leg ulceration.
• Venous leg ulcers typically appear on the lower shin, often near the medial malleolus, with specific tissue and skin changes.
• Arterial leg ulcers stem from arterial insufficiency, presenting as distinct round, dry ulcers with characteristic skin alterations.
• Effective ulcer therapy involves comprehensive wound management, including cleansing, debridement, disinfection, and the use of advanced bio-occlusive dressings.
• Systemic treatments like vascular protectors, venotonics, and antiaggregation medications complement topical wound care for CVI-related ulcers.

Impact:

• Improved understanding of CVI pathophysiology and ulcer differentiation aids in accurate diagnosis.
• Highlights the efficacy of advanced bio-occlusive dressings in managing challenging venous leg ulcers.
• Provides a framework for integrated therapeutic approaches, combining local wound care with systemic treatments for better patient outcomes.