July 1992

Leg Ulcers: A Practical Approach to Management

Author Affiliations

Atlanta, Ga


By David Negus, 181 pp with illus, $80, Stoneham, Mass, Butterworths, 1991.

Arch Surg. 1992;127(7):869. doi:10.1001/archsurg.1992.01420070137029

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This is a practical and clinically oriented guide to the management of the challenging problem of leg ulcers.

In part 1, the text begins with an interesting note on the historical background of the diagnosis and management of venous and ischemic ulcers. This is followed by an account on the epidemiologic aspects of the problem in which its extent in the United States and Europe is outlined. Next, venous anatomy and relevant embryology are discussed, with particular emphasis on their clinical implications. The next two chapters are devoted to the physiology of the muscle pumps of the lower limbs and the pathophysiology of leg ulcers, with reference to the venous disorders responsible for ulceration. The chapter concludes with a note on current theories of the mechanisms of impairment of the microcirculation in venous ulcers.

Part 2 of the book is directed to the practical management of leg ulcers. This begins

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