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Arterial Venous Ulcers Comparison Essay

1. London NJ, Donnelly R. ABC of arterial and venous disease. Ulcerated lower limb. BMJ. 2000;320:1589–91.[PMC free article][PubMed]

2. Saraf SK, Shukla VK, Kaur P, Pandey SS. A clinico-epidemiological profile of non-healing wounds in an Indian hospital. J Wound Care. 2000;9:247–50.[PubMed]

3. Stevens J, Franks PJ, Harrington M. A community/hospital leg ulcer service. J Wound Care. 1997;6:62–8.[PubMed]

4. Scottish Leg Ulcer Trial Participants. Effect of a national community intervention programme on healing rates of chronic leg ulcer: Randomised controlled trial. Phlebology. 2002;17:47–53.

5. Dodds SR. Shared community-hospital care of leg ulcer using an electronic record and telemedicine. Int J Low Extrem Wounds. 2002;1:260–70.

6. Nelzén O, Bergqvist D, Lindhagen A. Venous and non-venous leg ulcers: Clinical history and appearance in a population study. Br J Surg. 1994;81:182–7.[PubMed]

7. Stacey MC, Burnand KG, Layer GT, Pattison M, Browse NL. Measurement of the healing of venous ulcers. Aust N Z J Surg. 1991;61:844–8.[PubMed]

8. Yang D, Morrison BD, Vandongen YK, Singh A, Stacey MC. Malignancy in chronic leg ulcers. Med J Aust. 1996;164:718–20.[PubMed]

9. Samad A, Hayes S, French L, Dodds S. A comparative study of computerised digital image tracing versus contact tracing for objective measurement of leg ulcers. J Wound Care. 2002;11:137–40.[PubMed]

10. Moffatt CJ, Oldroyd MI, Greenhalgh RM, Franks PJ. Palpating ankle pulses is insufficient in detecting arterial insufficiency in patients with leg ulceration. Phlebology. 1994;9:170–2.

11. Yao ST, Hobbs JT, Irvine WT. Ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg. 1969;56:676–9.[PubMed]

12. Male S, Coull A, Murphy-Black T. Preliminary study to investigate the normal range of Ankle Brachial Pressure Index in young adults. J Clin Nurs. 2007;16:1878–85.[PubMed]

13. Stubbing NJ, Bailey P, Poole M. Protocol for accurate assessment of ABPI in patients with leg ulcers. J Wound Care. 1997;6:417–8.[PubMed]

14. Simon DA, Freak L, Williams IM, McCollon CN. Progression of arterial disease in patient with healed venous ulcers. J Wound Care. 1994;3:179–80.

15. Scriven JM, Hartshorne T, Bell PR, Naylor AR, London NJ. Single-visit venous ulcer assessment clinic: The first year. Br J Surg. 1997;84:334–6.[PubMed]

16. Lazarides MK, Giannoukas AD. The role of hemodynamic measurements in the management of venous and ischemic ulcers. Int J Low Extrem Wounds. 2007;6:254–61.[PubMed]

17. Grabs AJ, Wakely MC, Nyamekye I, Ghauri AS, Poskitt KR. Colour duplex ultrasonography in the rational management of chronic venous leg ulcers. Br J Surg. 1996;83:1380–2.[PubMed]

18. Androulakis AE, Giannoukas AD, Labropoulos N, Katsamouris A, Nicolaides AN. The impact of duplex scanning on vascular practice. Int Angiol. 1996;15:283–90.[PubMed]

19. van Bemmelen PS, Bedford G, Beach K, Strandness DE. Quantitative segmental evaluation of venous valvular reflux with duplex ultrasound scanning. J Vasc Surg. 1989;10:425–31.[PubMed]

20. Senet P, Combemale P, Debure C, Baudot N, Machet L, Aout M, et al. Malignancy and chronic leg ulcers: The value of systematic wound biopsies: A prospective, multicenter, cross-sectional study. Arch Dermatol. 2012;148:704–8.[PubMed]

21. Serena TE, Robson MC, Cooper DM, Ignatius J. Lack of reliability of clinical/visual assessment of chronic wound infection: The incidence of biopsy-proven infection in venous leg ulcers. Wounds. 2006;18:197–202.

22. Serena TE, Hanft JR, Snyder R. The lack of reliability of clinical examination in the diagnosis of wound infection: Preliminary communication. Int J Low Extrem Wounds. 2008;7:32–5.[PubMed]

23. Gardner SE, Frantz RA, Hillis HL, Park H, Scherubel M. Diagnostic validity of semiquantitative swab cultures. Wounds-a Compendium of Clinical Research and Practice. 2007;19:31–8.[PubMed]

24. Robson MC, Heggers JP. Bacterial quantification of open wounds. Mil Med. 1969;134:19–24.[PubMed]

25. Schraibman IG. The significance of beta-haemolytic streptococci in chronic leg ulcers. Ann R Coll Surg Engl. 1990;72:123–4.[PMC free article][PubMed]

26. Paramsothy Y, Collins M, Smith AG. Contact dermatitis in patients with leg ulcers. The prevalence of late positive reactions and evidence against systemic ampliative allergy. Contact Dermatitis. 1988;18:30–6.[PubMed]

27. Wilson CL, Cameron J, Powell SM, Cherry G, Ryan TJ. High incidence of contact dermatitis in leg-ulcer patients: Implications for management. Clin Exp Dermatol. 1991;16:250–3.[PubMed]

28. Zaki I, Shall L, Dalziel KL. Bacitracin: A significant sensitizer in leg ulcer patients? Contact Dermatitis. 1994;31:92–4.[PubMed]

29. Kulozik M, Powell SM, Cherry G, Ryan TJ. Contact sensitivity in community-based leg ulcer patients. Clin Exp Dermatol. 1988;13:82–4.[PubMed]

30. O’Meara S, Cullum N, Majid M, Sheldon T. Systematic reviews of wound care management: (3) antimicrobial agents for chronic wounds; (4) diabetic foot ulceration. Health Technol Assess. 2000;4:1–237.[PubMed]

31. Fernandez R, Griffiths R, Ussia C. The Cochrane Library. Chichester: John Wiley and Sons Ltd; 2003. Water for Wound Cleansing.

32. Kunimoto BT. Management and prevention of venous leg ulcers: A literature-guided approach. Ostomy Wound Manage. 2001;47:36.[PubMed]

33. Fowler E, van Rijswijk L. Using wound debridement to help achieve the goals of care. Ostomy Wound Manage. 1995;41:23S–35.[PubMed]

34. Berger MM. Enzymatic debriding preparations. Ostomy Wound Manage. 1993;39:61.[PubMed]

35. Fowler E. Instrument/sharp debridement of non-viable tissue in wounds. (28-3032).Ostomy Wound Manage. 1992;38:26.[PubMed]

36. Attinger CE, Janis JE, Steinberg J, Schwartz J, Al-Attar A, Couch K. Clinical approach to wounds: Débridement and wound bed preparation including the use of dressings and wound-healing adjuvants. Plast Reconstr Surg. 2006;117:72S–109.[PubMed]

37. Falabella AF. Debridement and management of exudative wounds. Dermatol Ther. 1999;9:36–43.

38. Bradley M, Cullum N, Sheldon T. The debridement of chronic wounds: A systematic review. (1-78).Health Technol Assess. 1999;3:iii–iv.[PubMed]

39. Paddle-Ledinek JE, Nasa Z, Cleland HJ. Effect of different wound dressings on cell viability and proliferation. Plast Reconstr Surg. 2006;117:110S–8.[PubMed]

40. Falanga V, Margolis D, Alvarez O, Auletta M, Maggiacomo F, Altman M, et al. Rapid healing of venous ulcers and lack of clinical rejection with an allogeneic cultured human skin equivalent. Human Skin Equivalent Investigators Group. Arch Dermatol. 1998;134:293–300.[PubMed]

41. Bowler PG, Davies BJ. The microbiology of acute and chronic wounds. Wounds. 1999;11:72–8.

42. Trengove NJ, Stacey MC, McGechie DF, Mata S. Qualitative bacteriology and leg ulcer healing. J Wound Care. 1996;5:277–80.[PubMed]

43. Ho KM, Litton E. Use of chlorhexidine-impregnated dressing to prevent vascular and epidural catheter colonization and infection: A meta-analysis. J Antimicrob Chemother. 2006;58:281–7.[PubMed]

44. Drosou A, Falabella A, Kirsner RS. Antiseptics on wounds: An area of controversy. Wounds. 2003;15:149–66.

45. Fumal I, Braham C, Paquet P, Piérard-Franchimont C, Piérard GE. The beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: A proof-of-concept study. Dermatology. 2002;204(Suppl 1):70–4.[PubMed]

46. Moore K, Thomas A, Harding KG. Iodine released from the wound dressing Iodosorb modulates the secretion of cytokines by human macrophages responding to bacterial lipopolysaccharide. Int J Biochem Cell Biol. 1997;29:163–71.[PubMed]

47. Mertz PM, Oliveira-Gandia MF, Davis SC. The evaluation of a cadexomer iodine wound dressing on methicillin resistant Staphylococcus aureus (MRSA) in acute wounds. Dermatol Surg. 1999;25:89–93.[PubMed]

48. Danielsen L, Cherry GW, Harding K, Rollman O. Cadexomer iodine in ulcers colonised by Pseudomonas aeruginosa. J Wound Care. 1997;6:169–72.[PubMed]

49. Zhou LH, Nahm WK, Badiavas E, Yufit T, Falanga V. Slow release iodine preparation and wound healing: In vitro effects consistent with lack of in vivo toxicity in human chronic wounds. Br J Dermatol. 2002;146:365–74.[PubMed]

50. Wunderlich U, Orfanos CE. Treatment of venous ulcera cruris with dry wound dressings. Phase overlapping use of silver impregnated activated charcoal xerodressing. Hautarzt. 1991;42:446–50.[PubMed]

51. Tebbe B, Orfanos CE. Therapy of leg ulcers and decubitus ulcers with a xero-dressing: Modern wound dressings with antibacterial activity. H + G Brand (Special Edition) 1996;71:11–3.

52. Bornier C, Jeannin C. Clinical trials with ACTISORB: Carried out on 20 cases of complex wounds. Soins Chir. 1989;99:39–41.[PubMed]

53. Cassino R, Ricci E, Carousone A. In: 10thEuropean Wound Management Association Conference. Dublin: 2001. Management of infected wounds: A review of antibiotic and antiseptic treatments (Poster Presentation)

54. Sibbald RG, Browne AC, Coutts P, Queen D. Screening evaluation of an ionized nanocrystalline silver dressing in chronic wound care. Ostomy Wound Manage. 2001;47:38–43.[PubMed]

55. O’Meara S, Al-Kurdi D, Ovington LG. The Cochrane Library. No. 1. Chichester: John Wiley and Sons Ltd; 2010. Antibiotics and antiseptics for venous leg ulcers.

56. Alinovi A, Bassissi P, Pini M. Systemic administration of antibiotics in the management of venous ulcers. A randomized clinical trial. J Am Acad Dermatol. 1986;15:186–91.[PubMed]

57. Fletcher A, Cullum N, Sheldon TA. A systematic review of compression treatment for venous leg ulcers. BMJ. 1997;315:576–80.[PMC free article][PubMed]

58. Cullum N, Nelson EA, Fletcher AW, Sheldon TA. The Cochrane Library. No. 2. Chichester: John Wiley and Sons Ltd; 2001. Compression for venous leg ulcers. [PubMed]

59. O’Meara S, Cullum NA, Nelson EA. The Cochrane Library. No. 1. Chichester: John Wiley and Sons Ltd; 2009. Compression for venous leg ulcers (Review)

60. O’Brien JF, Grace PA, Perry IJ, Hannigan A, Clarke Moloney M, Burke PE. Randomized clinical trial and economic analysis of four-layer compression bandaging for venous ulcers. Br J Surg. 2003;90:794–8.[PubMed]

61. Gaylarde PM, Sarkany I, Dodd HJ. The effect of compression on venous stasis. Br J Dermatol. 1993;128:255–8.[PubMed]

62. Zimmet SE. Venous leg ulcers: Modern evaluation and management. Dermatol Surg. 1999;25:236–41.[PubMed]

63. Hampton S. Venous leg ulcers: Short-stretch bandage compression therapy. Br J Nurs. 1997;6:990–2. 994, 996-8. [PubMed]

64. Cooper SM, Hofman D, Burge SM. Leg ulcers and pain: A review. Int J Low Extrem Wounds. 2003;2:89–97.[PubMed]

65. Franks PJ, Oldroyd MI, Dickson D, Sharp EJ, Moffatt CJ. Risk factors for leg ulcer recurrence: A randomized trial of two types of compression stocking. Age Ageing. 1995;24:490–4.[PubMed]

66. Briggs M, Nelson EA. The Cochrane Library. No. 1. Chichester: John Wiley and Sons Ltd; 2003. Topical agents or dressings for pain in venous ulcers. [PubMed]

67. Jull AB, Waters J, Arroll B. The Cochrane Library. No. 1. Chichester: John Wiley and Sons Ltd; 2002. Pentoxifylline for treatment of venous leg ulcers.

68. Marques da Costa R, Jesus FM, Aniceto C, Mendes M. Double-blind randomized placebo-controlled trial of the use of granulocyte-macrophage colony-stimulating factor in chronic leg ulcers. Am J Surg. 1997;173:165–8.[PubMed]

69. Da Costa RM, Ribeiro Jesus FM, Aniceto C, Mendes M. Randomized, double-blind, placebo-controlled, dose- ranging study of granulocyte-macrophage colony stimulating factor in patients with chronic venous leg ulcers. Wound Repair Regen. 1999;7:17–25.[PubMed]

70. Halabe A, Ingber A, Hodak E, David M. Granulocyte-macrophage colonystimulating factor: A novel therapy in the healing of chronic ulcerative lesions. Med Sci Res. 1995;23:65–6.

71. Pojda Z, Struzyna J. Treatment of non-healing ulcers with rhGM-CSF and skin grafts. Lancet. 1994;343:1100.[PubMed]

72. Jaschke E, Zabernigg A, Gattringer C. Recombinant human granulocyte-macrophage colony-stimulating factor applied locally in low doses enhances healing and prevents recurrence of chronic venous ulcers. Int J Dermatol. 1999;38:380–6.

Please Note

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Venous Stasis & Arterial Ulcer Comparison

Type of Wound


Risk Factors

Venous Ulcer

Arterial Ulcer

  • Full thickness wound
  • Punched out appearance
  • Wound edges are smooth
  • Individual may complain of pain nocturnally; pain can be relieved by lowering the leg below heart level (i.e. dangling leg over the edge of the bed).
  • Individuals prefer to sleep in a chair which impacts negatively on healing potential
  • Located mainly on the lateral foot, but can occur anywhere on the lower leg or foot
  • Lower extremities cool to touch
  • Skin is pale, shiny, taut, and thin
  • Periwound skin pale
  • Minimal to no hair
  • growth on lower limbs
  • Minimal drainage
  • Wound bed contains bright red granulation tissue
  • May be secondary to peripheral arterial disease
  • Vascular insufficiency
  • Uncontrolled Diabetes Mellitus with poor glycemic control
  • Limited joint mobility
  • Inadequate footwear
  • Structural foot abnormality, ie. Charcot foot
  • Retinopathy (poor eye sight)
  • renal disease
  • History of ulcers
  • Increased age