Venous Ulcer

Question 1

Cause of venous ulcer

Answer 1

3 from CVI

Question 2

Investigations

Answer 2

1. Exclude infection
   - Blood test of total whites/CRP
   - Wound swab for gram stain
   - X ray to check for involvement
2. Venous duplex ultrasound
3. Any peripheral arterial disease with ABPI/TPI
4. Refer to dermatologist for other conditions
5. Biopsy venous ulcer if cannot rule out SCC

Question 3

What is the management for venous ulcers

Answer 3

Conservative - 30-40mmHg

1. 4 layer compression stock of 30-40mmhg: Menolin, crepe bandage, blue line bandage and adhesive bandage
2. Antibiotics
3. Analgesia
4. Elevate leg
5. Compression stockings for life
6. Avoid trauma

Surgical intervention
Biopsy, skin graft +/- endovenous ablation