Dermatológia pre prax 1/2014

Therapy of venous leg ulcer

Venous leg ulcer (VLU) is the final stage of chronic venous disease of high incidence, which significantly reduces quality of life and generates huge costs, remains a major public heath issue. Its management is based mainly on his knowledge about pathophysiologie and the levels of clinical evaluation in CVI changes in the superficial and/or deep veins. The therapeutics options in management of venous ulceration are non – surgical and surgical treatments. Non – surgical treatment: venotropic drugs, local treatment (debridement, dressings) compression therapy (author prefers inelastic oxide zinc – bandaging with Varolast). Surgical treatment: by superficial and perforating incompetence saphenous ablation/(crossectomie and stripping VSM/VSP/perforators) or endovenoous surgery (laser, radiofrequency). By deep venous incompetence valve surgery. Operative techniques involving the fascia cruris (paratibibal fasciotomy, fasciectomy). Local ulcer surgery (excision, shave therapy, skin graft).

Keywords: venous leg ulcer (VLU), management, non surgical therapy, compression, surgical therapy, superficial and perforating incompetence, deep venous incompetence.