Determining venous incompetence: a report from a specialised leg ulcer clinic.
OBJECTIVE
To analyse the diagnosis, treatment and prognosis in patients attending a specialised leg ulcer clinic at a dermatology department.


METHODS
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.


CONCLUSIONS
Classification of venous insufficiency should be mandatory in patients with venous ulcers since it determines suitability for venous surgery.
Bjellerup
M
M
Department of Dermatology, Helsingborg Hospital, Helsingborg, Sweden. mats.bjellerup@helsingborgslasarett.se
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011159:Population Surveillance; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D053828:Stockings, Compression; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014689:Venous Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D014945:Wound Healing