1. Section Editor(s): Hess, Cathy Thomas BSN, RN, CWOCN

Article Content

An overview of chronic wound characteristics.



Predisposing Factors/Cause

Valve incompetence in perforating veins, history of deep vein thrombophlebitis and thrombosis, failed calf pump, history of venous ulcers or family history of ulcers, obesity, age, pregnancy (in women with a family history of venous ulcers)


Location and Depth

May occur anywhere between the knee and ankle, with medial and lateral malleolus the most common sites; usually shallow


Wound Bed and Wound Appearance

Variable appearance, frequently ruddy, "beefy" red, granular tissue; calcification in wound base is common; a superficial fibrinous "gelatinous" necrosis may occur suddenly with healthy appearing granulation tissue underneath



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Frequently moderate to heavy exudate


Wound Shape and Margins

Tend to be large with irregular margins


Surrounding Skin

Pigmented, edematous, macerated; characterized by hyperpigmentation, dermatitis, and lipodermatosclerosis; often accompanied by livedo reticularis; atrophie blanche may be present



Varies unpredictably; small but deep ulcers around malleoli are typically the most painful; pain often improves with leg elevation



Epithelialization often fails despite good granulation; average time to healing (based on combined literature) is 53 weeks, depending on degree of venous insufficiency, extent of lipodermatosclerosis, and presence of cardiovascular disease