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Venous Leg Ulcers

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Key Points 2 ➤ Venous leg ulcers (VLUs) are the most common ulceration on the lower extremity, accounting for 70% of all leg ulcers with a prevalence ranging between 0.06% and 2%. ➤ It has been estimated that approximately 2.5 million people suffer from chronic venous insufficiency in the United States, and of those, about 20% develop venous ulcers. Diagnosis Table 1. Standardized Venous Anatomy Nomenclature of the Pelvis Main collector Draining veins Plexus and peripheral veins Inferior vena cava • Ovarian/testicular veins • Pampiniform plexus Common iliac vein • Median sacral vein • Iliolumbar vein • Internal iliac (hypogastric) • External iliac • Sacral venous plexus Inferior mesenteric vein • Superior rectal vein • Middle rectal vein • Inferior rectal vein • Superior gluteal vein • Inferior gluteal vein • Lateral sacral vein • External rectal plexus • Internal rectal plexus Internal iliac vein • Internal pudendal vein • Obturator veins • Vesical veins • Uterine veins • Vaginal veins • Deep perineal veins • Superficial perineal veins • Deep dorsal veins of clitoris/ penis • Deep veins of clitoris/penis • Urethral bulb veins • Pudendal plexus • Vesical/prostatic plexus • Uterine plexus • Vein of the broad ligament • Vaginal plexus External iliac vein • Pubic veins (accessory obturator veins) • Sovrapubic veins • Inferior epigastric vein • Deep circumflex iliac vein Modified from Caggiati A, Bergan JJ, Gloviczki P, Eklof B, Allegra C, Partsch H. Nomenclature of the veins of the lower limb: Extensions, refinements, and clinical application J Vasc Surg 2005;41:719-24.

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