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Journal . Date of publication 2017 Oct 7;volume ():.

Abstract A venous ulcer is a wound, usually on the medial maleolus, ankle or calf, that results from venous insufficiency or elevated venous pressure. It is considered chronic if it is unresponsive (reduces in area less than 40% in 3 weeks (Phillips et al., 2000)) to best evidence-based care The resulting local edema can progress to dermatitis and ulceration. It may result from incompetent venous valves in the superficial, perforator or deep vein systems and/or inadequate calf muscle pump function(American Society of Plastic Surgeons, 2007; Wound Ostomy Continence Nurses Society, 2005). Strength of Evidence Ratings A. Results of a meta-analysis or two or more venous ulcer (VU)-related randomized controlled trials (RCT) on humans provide support. For diagnostics or risk assessment screening: prospective cohort (CO) studies and/or controlled studies reporting recognized diagnostic (e.g. sensitivity or specificity) or screening (e.g. + or -predictive validity) measures. B. Results of one VU-related RCT in humans plus one or more similar Historically Controlled Trials (HCT) or Convenience Controlled Trials (CCT) or one HCT and one CCT provide support or when appropriate, results of two or more RCT in animal model validated as clinically relevant to VU provide indirect support. For diagnostics or risk assessment one VU-related prospective cohort (CO) study and/or a controlled study reporting recognized diagnostic or predictive screening validity measures.

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