Pathophysiology of venous ulceration

Diagnosis and management of venous leg ulcers

“…It is thought that venous hypertension stimulates the “trapping” of white blood cells in capillaries or post-capillary venules, which are subsequently activated, causing the release of inflammatory mediators leading to tissue injury, poor healing, and ultimately necrosis. The “fibrin cuff theory” proposes that the deposition of fibrin around cutaneous capillaries results in skin hypoxia and thus ongoing poor healing with further local inflammation 1415…”

Factors Associated to the Cicatrization Success of Lower-Limb Ulcer of Venous Etiology

“…These modifications produce physiological alterations, like capillary leak, fibrin deposition, sequestration of leukocytes and erythrocytes, thrombocytosis, and inflammation, which harms oxygenation of the skin and nearby tissue, favoring tissue hypoxia. (3) Care of patients suffering from UVE requires an evaluation and specialized treatment and, on occasion, interdisciplinary due to the multi-causal origin, manifestations on skin, cardiovascular compromise, magnitude and consequence of the damage. Besides the bodily affection, it compromises the quality of life of those who suffer it in the emotional, spiritual, social, and aesthetic dimensions, (4) specifically due to issues associated to constant pain, deterioration of the bodily image, isolation, and difficulty in performing daily living activities.…”

The role of free iron in cardiovascular diseases. Part II

“…Further studies highlight the relation between tissue iron overload and venous ulcers and some HFE polymorphism (hemochromatosis gene) [121][122][123][124][125] and also provided therapy evidence by using topical chelating agents which fasten the venous ulcer healing process 126,127 . Some authors 128 used the PIXE (Proton Induced X-ray Emission Spectroscopy) to highlight that the iron concentration rises with the evolution of the disease; in fact, the iron deposition rate is higher in incompetent veins compared to competent veins (surgically collected veins); this rate is statistically correlated to oxidative stress parameters and to the ratio intima-media.…”