Venous ulceration

Question 1

Venous ulceration is typically seen

Answer 1

medial malleolus

Question 2

Venous ulceration investigation

Answer 2

ankle-brachial pressure index (ABPI) is important in non-healing ulcers to assess for poor arterial flow which could impair healing

a ‘normal’ ABPI may be regarded as between 0.9 - 1.2. Values below 0.9 indicate arterial disease. Interestingly, values above 1.3 may also indicate arterial disease,

Question 3

management of venous ulceration ?

Answer 3

compression bandaging, usually four layer (only treatment shown to be of real benefit)

oral pentoxifylline, a peripheral vasodilator, improves healing rate
small evidence base supporting use of flavinoids

little evidence to suggest benefit from hydrocolloid dressings, topical growth factors, ultrasound therapy and intermittent pneumatic compression