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Single-visit venous ulcer assessment clinic: the first year
J M Scriven1, T Hartshorne, P R Bell
1Department of Surgery, University of Leicester, UK.
The British Journal of Surgery
|March 1, 1997
Summary
A dedicated clinic found that 14% of leg ulcers had arterial issues, and over half of venous ulcers could benefit from superficial venous surgery. Clinical assessment alone is insufficient for diagnosing venous reflux or deep vein thrombosis.
Area of Science:
- Vascular Surgery
- Dermatology
- Wound Care
Background:
- Venous ulceration presents a substantial clinical challenge for healthcare providers and patients.
- A specialized, single-visit venous ulcer assessment clinic was established to improve patient management.
- The clinic aimed to provide comprehensive evaluation and diagnosis for leg ulcers.
Purpose of the Study:
- To prospectively assess patients referred to a dedicated venous ulcer clinic.
- To classify leg ulcers based on vascular etiology using clinical and duplex ultrasound assessments.
- To determine the prevalence of venous reflux and its patterns in ulcerated limbs.
Main Methods:
- Prospective data collection from patients attending the venous ulcer clinic.
- Clinical assessment combined with color-coded venous and arterial duplex scanning.
- Classification of ulcers as venous, arterial, mixed, or non-vascular based on ankle-brachial pressure indices and venous duplex findings.
Main Results:
- Eighty-eight patients (104 limbs) were evaluated, with 79% of ulcers being venous.
- A significant arterial component was found in 14% of leg ulcers.
- Venous reflux was identified in 95 limbs, with superficial system involvement in 57%.
Conclusions:
- Over half of venous ulcers may be suitable for superficial venous surgery.
- Clinical assessment alone is often inadequate for detecting superficial venous reflux or prior deep vein thrombosis.
- Accurate diagnosis requires objective vascular assessment, including duplex scanning.
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