Ulcus cruris venosum – Venous Leg Ulcers
therapy concept
After the necessary initial decongestion phase of the accompanying edema with compression bandages, the treatment should be switched to two-layer ulcer compression stocking systems for long-term therapy in suitable cases (see Guideline for Medical Compression Therapy 2018, Recommendation 26).
Emergence and therapy
Venous leg ulcers, also known as ulcus cruris venosum (Latin: ulcus = ulcer, crus = lower leg, vena = blood vessel), refer to deep wounds that heal poorly and mainly occur in the ankle region and lower leg. The term “venosum” relates to the origin of the condition: an ulcus cruris venosum develops as a result of circulatory disorders that cause tissue damage in the skin and subcutaneous tissue. Thrombosis or chronic venous insufficiency (CVI) is often responsible for this condition. CVI refers to the cumulative clinical changes in the skin and subcutaneous tissue that occur within a chronic venous disease. An ulcus cruris represents the most severe form of this progression.
Symptoms
Visible symptoms and warning signs of CVI include increased pigmentation of the skin (brown patches) and vascular markings that extend in a spiderweb-like pattern over the inner edge of the foot and the inner ankle (corona phlebectatica). Persistent tissue damage caused by CVI can lead to ulcer-like and poorly healing wounds. In severe cases, such a venous leg ulcer can also result in necrosis of the skin tissue. This process can be accompanied by intense and painful discomfort.
CEAP Classification Of Venous Disorders
C 0
no visible or palpable signs
of venous disease
C 1
telangiectasies
reticular veins
C 2
varicose veins
C 4
varicosis with
trophic skin changes
C 6
active venous ulcer
Causes
In 72% of cases, venous insufficiency (venous leg ulcer) is the main cause of a leg ulcer and an additional 14% of cases involve venous insufficiency (mixed leg ulcer). Other causes such as arterial circulatory disorders (peripheral arterial occlusive disease, PAD) and conditions like rheumatism, metabolic disorders (e.g., diabetes mellitus), and infections can also contribute to the development of leg ulcers.
