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General Reference ⬇

Nejm 2006;355:488; Ann IM 2003;138:326

Pathophys and Cause ⬆ ⬇

Cause: Venous insufficiency

Signs and Symptoms ⬆ ⬇

Si:Medial > lateral changes and ulcers in lower extremity, especially over malleoli

Complications ⬆ ⬇

r/o arterial ulcers (lateral, no P's, diminished ankle/brachial index)

Treatment ⬆

Rx:

Prevent (Nejm 2009;360:2319) w Ace wraps, elastic stockings w pressures >35 mm at ankle, elevation

Treat w stoma adhesive qd; Banoxyl, perhaps pentoxifylline (ACP J Club 2001;134:14); if <6 mo old and <5 cm2 area, healing w q 1 wk Zn oxide (Unna) boot likely w/i 6 mos (Am J Med 2000;109:15)

ASA 300 mg po qd by DBCT

Surgical skin grafts