<prompt> True about venous ulcerAlways stripping doneAlways examine deep venous systemBiopsy should be taken from chronic ulcerAw Klippel-Trenaunary syndrome  <response>: Venous Ulcers Causes of Leg ulcers Venous disease : Superficial incompetence ; deep venous damage post - thrombotic Aerial ISchemic ulcers Rheumatoid ulcers Traumatic ulcers Neuropathic ulcers Diabetes Neoplastic ulcers SCC and BCC Clinical features Venous ulcers: Sloping edge, base contains granulation tissue covered by Slough and exudate Any elevation of the ulcer edge should indicate the need for a biopsy to exclude a carcinoma SCC or BCC Venous ulcer of the leg characteristically develops in the skin of the gaiter region, the area between muscles of the calf ankle Majority of ulcers develop on the medial side of the calf Ulcers associated with lesser saphenous incompetence often develop on the lateral side of the leg Almost all venous ulcers have surrounding lipdermatosclerosis thickening, pigmentation, inflammation induration of calf skin Pigmentation comes from hemosiderin melanin Presence of ankle flare suggests venous hypeension Diagnosis Duplex Ultra sound : Assess the state of deep superficial veins IOC Bipedal ascending phlebography :Detect obstruction post-thrombotic changes missed by the duplex scan Management Probable venous ulcer : Patients are initially treated by a compression bandaging regimen. A multilayered elastic compression bandaging system has been shown to be effective Chariging Cross four-layer bandage, as has a rigid multilayered system Steripaste three layer bandage Ref: Sabiston 20th edition Pgno :1832 