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Venous Insufficiency Ulcers

Marcy R Wiemers, MD, Hyunyoung G Kim, MD, MPH and Rachel P Walker, BA, MD. Reviewed 06/2022
 


BASICS

  • Venous insufficiency is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart and causing...

DIAGNOSIS

HISTORY

  • Family history of venous insufficiency and ulcers

  • Recent trauma

  • Prevalent features: cramping, pruritus, prickling, and throbbing sensation

  • Pain that may improve with leg elevation

  • Wound d...

TREATMENT

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

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

GENERAL MEASURES

  • Compress...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

When ulcers are nearly healed and edema is controlled, switch from compression bandages to compression hose. (Consider referral for compression hose fitting early...

REFERENCES

1
Bonkemeyer Millan S, Gan R, Townsend PE. Venous Ulcers: Diagnosis and Treatment. Am Fam Physician. 2019 Sep 1;100(5):298-305.
2
Ren SY, Liu YS, Zhu GJ, et al. Strategies and challenges in th...

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

  • The diagnosis of venous ulcers is clinical; however, exams such as ABI and color duplex ultrasonography may be helpful if the diagnosis is unclear.

  • Compression therapy is the standard o...

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