RECENT TRENDS IN SURGICAL TREATMENT OF CHRONIC LEG &FOOT ULCER

Abstract

Chronic leg ulcer is defined as a defect in the skin below the level of knee persisting for more than six weeks and shows no tendencyto heal after three or more months. Chronic ulceration of the lower legs is a relatively common condition amongst adults, one thatcauses pain and social distress. The condition affects 1% of the adult population and 3.6% of people older than 65 years.

Leg ulcersare debilitating and greatly reduce patients’ quality of life. The common causes are venous disease, arterial disease, and neuropathy.Less common causes are metabolic disorders, hematological disorders, and infective diseases.

As many factors lead to chroniclower leg ulceration, an interdisciplinary approach to the systematic assessment of the patient is required, in order to ascertain thepathogenesis, definitive diagnosis, and optimal treatment. A correct diagnosis is essential to avoid inappropriate treatment thatmay cause deterioration of the wound, delay wound healing, or harm the patient.The treatment of chronic ulcers of thelower extremities presents a therapeutic challenge. There isclear evidence suggesting that causal treatment should havepriority. A comprehensive diagnostic evaluation includingvascular,metabolic, and physical aspects asmentioned aboveis essential at the start of treatment.