Venous Leg Ulcers

Leg ulcers are usually secondary to venous reflux or obstruction, but 20% of persons with leg ulcers have arterial disease, with or without venous disorders. Compression bandages and stockings heal more ulcers compared with no compression, but we do not know which compression technique is most effective. Compression is used for persons with ulcers caused by venous disease who have an adequate arterial supply to the foot. The effectiveness of compression bandages depends on the skill of the person applying them. Oral pentoxifylline increases ulcer healing in persons receiving compression. We do not know whether therapeutic ultrasound, superficial vein surgery, skin grafting, leg ulcer clinics, laser treatment, or advice to elevate legs or increase activity increases healing of ulcers in persons treated with compression. Compression bandages and stockings reduce recurrence of ulcers compared with no compression, and should ideally be worn for life. Superficial vein surgery may also reduce recurrence.