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Indian Journal of Surgery

, Volume 80, Issue 2, pp 171–182 | Cite as

Evidence-Based Clinical Practice Points for the Management of Venous Ulcers

  • Ravul Jindal
  • D. B. Dekiwadia
  • Pinjala Rama Krishna
  • Ajay K. Khanna
  • Malay D. Patel
  • Shoaib Padaria
  • Roy Varghese
Review Article

Abstract

Venous ulcer is an extremely common aetiology of lower extremity ulceration, which affects approximately 1% population in most of the countries, and the incidence rate increases with age and female gender. Proper assessment and diagnosis of both the patient and ulcer are inevitable in order to differentiate venous ulcers from other lower extremity ulceration and to frame an adequate and individualised management plan. Venous ulcers generally persist for weeks to many years and are typically recurrent in nature. This consensus aims to present an evidence-based management approach for the patients with venous ulcers. Various management options for venous ulcers include compression therapy, minimally invasive procedures like sclerotherapy and ablation techniques, surgical procedures, debridement and medical management with micronised purified flavonoid fraction (MPFF). Compression therapy is the mainstay treatment for venous ulcer. However, in failure cases, surgery can be preferred. Medical management with MPFF as an adjuvant therapy to standard treatment has been reported to be effective and safe in patients with venous ulcer. In addition to standard therapy, diet and lifestyle modification including progressive resistance exercise, patient education, leg elevation, weight reduction, maintaining a healthy cardiac status and strong psychosocial support reduces the risk of recurrence and improves the quality of life in patients with venous ulcer.

Keywords

Venous ulcer Compression MPFF Surgical procedures Lifestyle modification 

Notes

Compliance with Ethical Standards

Conflict of Interests

All the authors declare that they have no conflict of interest.

Supplementary material

12262_2018_1726_MOESM1_ESM.docx (29 kb)
ESM 1 (DOCX 28 kb)

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Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  • Ravul Jindal
    • 1
  • D. B. Dekiwadia
    • 2
  • Pinjala Rama Krishna
    • 3
  • Ajay K. Khanna
    • 4
  • Malay D. Patel
    • 5
  • Shoaib Padaria
    • 6
  • Roy Varghese
    • 7
  1. 1.Fortis HospitalMohaliIndia
  2. 2.Dekiwadia HospitalRajkotIndia
  3. 3.NIZAMS Institute of Medical SciencesHyderabadIndia
  4. 4.Institute of Medical SciencesBanaras Hindu UniversityVaranasiIndia
  5. 5.Apollo HospitalAhmedabadIndia
  6. 6.Jaslok Hospital, Breach Candy Hospital, Sir H.N. Hospital, Saifee HospitalMumbaiIndia
  7. 7.Daya HospitalJubilee Mission Medical CollegeTrichurIndia

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