Management of leg ulcers
- Dr Sarkar
- Received 17 September 1999
- Accepted 6 March 2000
Abstract
Leg ulcer is a leading cause of morbidity among older subjects, especially women in the Western world. About 400 years BC, Hippocrates wrote, “In case of an ulcer, it is not expedient to stand, especially if the ulcer be situated on the leg”. Hippocrates himself had a leg ulcer. The best treatment of any leg ulcer depends upon the accurate diagnosis and the underlying aetiology. The majority of leg ulcers are due to venous disease and/or arterial disease, but the treatment of the underlying cause is far more important than the choice of dressing. The aetiology, pathogenesis, treatment, and the future trends in the management of the leg ulcers are discussed in this review.
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Treatment with compression bandages (three or four layers) hastens the healing of venous leg ulcers compared with no compression
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High compression is more effective than low compression provided there is no arterial insufficiency
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Intermittent pneumatic compression is a useful adjunct to compression bandaging
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Cultured epidermal autograft or allograft may be useful for chronic mixed ulcers
