The annual cost to the National Health Service is estimated to be in the region of 300-600 million. The majority of patients are cared for by community services. Venous ulceration can result from chronic venous hypertension in the lower limb, usually due to malfunctioning valves in the leg veins, of either congenital or acquired origin, resulting in a blackflow of blood. The subsequent leakage of red blood cells and large protein molecules creates the physiological conditions which can lead to ulcer formation. Often the lower limb is swollen with a brown discoloration of the skin and the prescence of an irritating eczema.
Arterial ulcers result from a reduced arterial circulation.
Smoking and poor diet are contributory factors. The lower limb may appear pale or a dusky red colour and the patient commonly complains of pain, particularly when the limb is elevated or during exercise. Leg ulceration impacts on the quality of daily life through pain, physical restrictions, sleep disturbances, reduced energy, emotional reactions and social isolation. Treatments Venous ulceration treatment aims to counteract the high pressure in the superficial veins, increase the calf muscle pump mechanism to assist venous return and reduce oedema. This is achieved by applying graduated compression from the toes to the knee.