[Venous ulcer--present view on aetiology, diagnostics and therapy].
The common aetiology of chronic wounds is chronic venous insufficiency. The prevalence of chronic venous insufficiency ranges from 5 to 8% and the prevalence of venous ulcers is about 1%. Venous ulcer is caused by induction of chronic inflammation. Chronic inflammation leads to deregulations of wound healing mechanisms. Senescent phenotype of wound healing cells is recorded as outcome of chronic inflammation. Diagnosis is based on classical clinical presentation of venous ulcer and on supporting examinations. Supporting examinations include duplex ultrasound, photoplethysmography, ankle brachial index investigation and examination of hemocoagulation status. Malignant transformation is a possible complication of venous ulcers. The relative risk of malignancy in chronic venous ulcers is 5.8%. The first step in venous ulcer treatment is debridement. There is no consensus in speculations about wound colonization treatment. However the signs of infection are indication for general antibiotics treatment. Local antiseptic therapy is increasingly used. On the other side local antibiotics therapy is not recommended. Compression is used as the mainstay of therapy. It is important to rule out arterial disease before initiating compression therapy. Dressings are used as an adjuvant therapy to compression. Venous ulcers treatment is an interdisciplinary problem. Large diagnostic and therapeutic methods are needed for its management.
Toporcer
T
T
II. Chirurgická klinika LF UPJS, Kosice, Slovenská republika. topyto@gmail.com
Lakyová
L
L
Radonak
J
J
D006801:Humans; D014647:Varicose Ulcer / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014689:Venous Insufficiency / Q000150:complications / Q000503:physiopathology