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Venous Insufficiency Ulcers

Marcy Wiemers, MD, Seena Mariate Jose, MD and Hyunyoung Kim, MD, MPH Reviewed 06/2020
 


BASICS

  • Venous insufficiency disorders include simple spider veins, varicose veins, and leg edema.

  • In the United States, up to 35% of adults have chronic venous insufficiency.

  • Venous leg ulcers are the m...

DIAGNOSIS

A diagnosis of venous reflux or obstruction must be established by an objective test beyond the routine clinical examination of the extremity. 

HISTORY

  • Family history of venous insufficiency a...

TREATMENT

  • Treatment options: conservative management, mechanical treatment, medications, and surgical options

  • Goals: Reduce edema, improve ulcer healing, and prevent recurrence

GENERAL MEASURES

  • Compressi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • When ulcers are nearly healed and edema is controlled, switch from compression bandages to compression hose.

  • Insurance may not reimburse for compression hose unles...

REFERENCES

1
O’Meara S, Al-Kurdi D, Ologun Y, et al. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev.  2014;(1):CD003557.
2
Latz CA, Brown KR, Bush RL. Compression ther...

ADDITIONAL READING

  • Jull A, Muchoney S, Parag V, et al. Impact of venous ulceration on health-related quality of life: a synthesis of data form randomized controlled trials compared to population norms...

CODES

ICD10

  • I87.2 Venous insufficiency (chronic) (peripheral)

  • I83.009 Varicose veins of unsp lower extremity w ulcer of unsp site

  • I89.0 Lymphedema, not elsewhere classified

  • I83.008 Varicos vn unsp low ext...

CLINICAL PEARLS

  • Venous stasis: dull ache or pain in lower extremities, swelling that subsides with elevation, changes of the surrounding skin, and varicose veins

  • Venous ulcers often occur over bony pro...

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