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| Venous
ulcers are the most common ulcer of the lower leg occurring
in ambulatory patients. The underlying etiology involves
vein damage or an incompetent calf muscle pump action
which leads to venous hypertension. As a result, blood
pools in the lower extremities causing edema and leakage
of fibrinogen and other blood products into the tissues.
Trauma to the area or increased pressure within the tissues
results in ulceration. |
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Venous leg ulcers typically share the following characteristics:
- Located above the medial malleolus and below the knee ("gaitor" region)
- Beefy, red wound base
- Wound edges intact without undermining
- Large with irregular shaped borders
- Superficial crater
- Moderate to heavy serous exudate
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| The ulcer is staged as partial-or
full-thickness. Partial-thickness ulcers involve the epidermis
and dermis, whereas full-thickness ulcers extend into
deeper tissue which may involve subcutaneous tissue, muscle,
bone, or other supporting structures. |
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The periwound and lower leg skin may have evidence of the following changes:
- Hyperpigmentation (brown/black discoloration)
- Dryness
- Erythema
- Weeping dermatitis
- Thickening of the skin (lipodermatosclerosis)
- Scaling
- Edema (non-pitting)
- Minimal pain unless infected or desiccated
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