Chronic venous ulcers with different approaches for treatment

Abstract

Leg ulceration affects approximately one out of every five patients with chronic venous insufficiency at some point, and many people experience recurrent ulceration episodes. There are two classifications for venous disorders: The classification of CEAP & the revised venous clinical severity score (r-VCSS). The duplex ultrasound is the gold standard diagnostic tool for chronic venous ulcers. There are many treatment options for chronic venous ulcer including: Compression treatment, superficial vein surgery (stripping or ligation of GSV) in case of truncal reflux, injection of autologous platelet-rich plasma and Perforator vein (PV) interruption procedures either surgically (SEPS) or with foam sclerotherapy. Foam sclerotherapy with ultrasound guidance has been used extensively to treat primary and recurrent superficial venous conditions. Ineffective perforator veins can be treated with sclerotherapy. Platelet rich plasma is widely used on the wound surface or injected in wound edges in chronic ulcers.