Diagnosis
4
Definition
➤ We suggest use of a standard definition of venous ulcer as an open
skin lesion of the leg or foot that occurs in an area affected by venous
hypertension. (BP)
Venous Anatomy and Pathophysiology
Venous Anatomy Nomenclature
➤ We recommend use of the International Consensus Committee on
Venous Anatomical Terminology for standardized venous anatomy
nomenclature. (BP) [Tables 1 and 2]
Venous Leg Ulcer Pathophysiology
➤ We recommend a basic practical knowledge of venous physiology
and venous leg ulcer pathophysiology for all practitioners caring for
venous leg ulcers. (BP)
Clinical Evaluation
Clinical Evaluation
➤ We recommend that for all patients with suspected leg ulcers fitting
the definition of venous leg ulcer, clinical evaluation for evidence of
chronic venous disease be performed. (BP)
Nonvenous Causes of Leg Ulcers
➤ We recommend identification of medical conditions that affect ulcer
healing and other nonvenous causes of ulcers. (BP)
Wound Documentation
➤ We recommend serial venous leg ulcer wound measurement and
documentation. (BP)
Wound Culture
➤ We suggest against routine culture of venous leg ulcers and only to
obtain wound culture specimens when clinical evidence of infection is
present. (2-C)
Wound Biopsy
➤ We recommend wound biopsy for leg ulcers that do not improve
with standard wound and compression therapy after 4–6 weeks of
treatment and for all ulcers with atypical features. (1-C)
