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A comprehensive guide to the assessment and treatment of leg ulcers. Different aspects of venous leg ulcers like epidemiology, examination with Doppler and duplex sonography, venography, functional assessments as well as the most common modern classifications are recapitulated. Also, conservative treatment methods such as compression therapy, mobilization of the ankle joint and lymph drainage or different surgical techniques for recalcitrant venous ulcers are discussed. The chapters dealing with diabetic foot ulcers give a general outlook including patient instruction, orthopaedic footwear and podiatric care along with management of the diabetic foot infection, and the indications for orthopaedic and vascular interventions.
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............................ Management of Leg Ulcers .. ............................ Current Problems in Dermatology Vol. 27 Series Editor G. Burg, Zu¨rich ............................ Management of Leg Ulcers Volume Editors J. Hafner, Zu¨rich A.-A. Ramelet, Lausanne W. Schmeller, Lu¨beck U.V. Brunner, Zu¨rich 78 figures, 23 in color, and 41 tables, 1999 ............................ J. Hafner A.-A. Ramelet Department of Dermatology University Hospital of Zu¨rich Gloriastrasse 31 CH–8091 Zu¨rich (Switzerland) 2, place Benjamin-Constant CH–1003 Lausanne (Switzerland) W. Schmeller U.V. Brunner Wesloer Landstr. 3k D–23566 Lu¨beck (Germany) Department of Surgery University Hospital of Zu¨rich Ra¨mistrasse 100 CH–8091 Zu¨rich (Switzerland) Library of Congress Cataloging-in-Publication Data Management of leg ulcers / volume editors, J. Hafner ... [et al.]. (Current problems in dermatology: vol. 27) Includes bibliographical references and indexes. 1. Leg – Ulcers. I. Hafner, J. (Ju¨rg). II. Series. [DNLM: 1. Leg Ulcer – therapy. 2. Leg Ulcer – diagnosis. 3. Leg ulcer – physiopathology. W1 CU804L v.27 1999] RC951.M315 1999 616.5 45––dc21 ISSN 0070–2064 ISBN 3–8055–6654–9 (hardcover: alk. paper) Bibliographic Indices. This publication is listed in bibliographic services, including Current ContentsÔ and Index Medicus. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Ó Copyright 1999 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free paper by Reinhardt Druck, Basel ISBN 3–8055–6654–9 ............................ Contents 1 Editors’ Portraits 3 Acknowledgment Introduction 4 Management of Leg Ulcers Hafner, J. (Zu¨rich); Ramelet, A.-A. (Lausanne); Schmeller, W. (Lu¨beck); Brunner, U.V. (Zu¨rich) Part I. Wound Healing 8 Molecular Biology of Chronic Wounds Ko¨nig, M.; Peschen, M. (Freiburg), Vanscheidt, W. (Ho¨chenschwand) 13 Cytokines in Progessing Stages of Chronic Venous Insufficiency Peschen, M (Freiburg) 20 Bacteriology of Leg Ulcers Ramelet, A.-A.; Perrenoud, D. (