MANAGEMENTOF CHRONIC VENOUS LEG ULCERS

SAMEH IBRAHIM MANSY;

Abstract


A leg ulcer is simply a break in the skin of the leg. The immediate cause is usually an injury, often a minor one that breaks the skin. In some people such an injury will heal up without difficulty within a week or two. However, if there is an underlying problem the skin does not heal and the area of breakdown may increase in size, this is a chronic leg ulcer.
Venous disease is the main reason for over two thirds of all leg ulcers. There are less common causes for leg ulcers such as disease of the m1eries, diabetes or rheumatoid m1hritis as well as a number of even rarer conditions. Which must be identified and investigated for the proper management.
Chronic venous leg ulcer is a common disease, where it
affects about 1-3% of the population, the diagnosis and treatment of the pathophysiological factors responsible for the ulcer formation is much more impm1ant than the treatment of the ulcer itself.
The venous system of the lower limb includes the superficial
veins and their tributaries, the perforating veins, the deep veins and the valves, the superficial veins act mainly as thermo-regulators while the deep veins act as passive blood conduits.
The blood is returned to the hem1against gravity by a number
of muscle pumps, mainly the calf muscle pump, the foot pump, the
. abdominal pump and respiratmy pump. The capacity and pressure profiles of the calf muscle pump is greater than all other pumping mechanisms and its disordered function is the most imp011ant factor in the etiology of the venous ulceration.
The legs contain one way valves that should allow blood to
flow up the leg veins and not back down. However, these valves are not vety effective in some people or can be damaged, blood can flow the wrong way down the veins which results in a vety high pressure in the veins when standing up. This abnormally high pressure in the veins damages the skin and leads to the ulcers.
Venous hypet1ension is the major error in cases of chronic
venous insufficiency.


Other data

Title MANAGEMENTOF CHRONIC VENOUS LEG ULCERS
Other Titles علاج قرح الساق الوريدية المزمنة
Authors SAMEH IBRAHIM MANSY
Issue Date 2002

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