Venous leg ulcers and microcirculation

Incompetence of venous valves do not lead per se to trophic skin changes of the lower limb. In severely concerned patients suffering from dermatoliposclerosis or venous leg ulcers retrograde pressure waves were detected in the nutritive capillaries of the skin by the "servo nulling" pressure measurement during simulated calf muscle contraction. Between the degree of trophic skin change and the capillary density and cutaneous oxygen partial pressure a close correlation was found. Healing of venous ulcers occurred only if the cutaneous microangiopathy in the ulcer area improved. Capillary density and transcutaneous oxygen partial pressure were of prognostic impact as to healing of venous ulcers.