Even with optimal treatment of venous ulcers, healing may be prolonged and/or ineffective, and recurrence rates remain quite high. How should wound care clinicians and vascular specialists collaborate with care planning? Venous ulceration represents the most advanced stage of chronic venous disease and is responsible for approximately 70% of all chronic leg ulcers.1-3 These ulcers affect approximately 1% of the population and are responsible for significant morbidity, decreased quality of life, and economic costs. Advanced venous disease may result from primary degenerative disorders or may be secondary to a previous episode of deep vein thrombosis (DVT). Additionally, venous ulceration may arise from venous valvular incompetence (reflux) in the superficial, deep, or perforating veins; from venous obstruction; or from a combination of both. Regardless of the underlying etiology, the final consequence is venous hypertension resulting in activation of the microvascular endothelium; leukocyte activation, adhesion, and migration; and inflammation ultimately leading to skin changes and ulceration … read more