Hopp til hovedinnhold

Kronisk leggsår

Kronisk leggsår er sår nedenfor kneet, gjerne i ankelregionen, som ikke gror i løpet av seks uker. Årsaken er svekket drenering av venøst blod fra leggen, for eksempel ved åreknuter.

Sist revidert:

QR
Del pasientinformasjon

Den ligger åpent tilgjengelig på NHI.no sammen annen relevant informasjon

https://nhi.no/sykdommer/hud/sar-hudskader-bitt/leggsar-venose/ 

Hva er kronisk leggsår?

Årsaker

Symptomer

Diagnosen

Behandling

Egenbehandling

Kompresjonsbehandling

Sårstell

Kirurgi

Generelle råd

Forebyggende behandling

Prognose

Vil du vite mer?

Kilder

Referanser

Dette dokumentet er basert på det profesjonelle dokumentet Leggsår, kronisk venøst. Referanselisten for dette dokumentet vises nedenfor.

  1. Wittens C, Davies AH, Bækgaard N, et al. Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015; 49:678. PubMed 
  2. Kirsner, R.S. and Vivas, A.C. Lower-extremity ulcers: diagnosis and management. British Journal of Dermatology, 2015. doi: 10.1111/bjd.13953 DOI 
  3. Slagsvold C-E, Stranden E. Venøse leggsår. Tidsskr Nor Lægeforen 2005; 125: 891-4. PubMed 
  4. O'Meara S, Al-Kurdi D, Ologun Y, et al. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014. 10;1:CD003557. doi: 10.1002/14651858.CD003557.pub5 DOI 
  5. Abbade LP, Lastória S. Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Int J Dermatol 2005; 44: 449-56. PubMed 
  6. Aziz Z, Cullum N. Electromagnetic therapy for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No.: CD002933. DOI: 10.1002/14651858.CD002933.pub6. DOI 
  7. Körber A, Klode J, Al-Benna S, et al. Etiology of chronic leg ulcers in 31,619 patients in Germany analyzed by an expert survey. J Dtsch Dermatol Ges 2011; 9:116. PubMed 
  8. Nelzén O. Leg Ulcers: Economic Aspects. Phlebologie 2000; 15: 110-4. PubMed 
  9. Nelson EA, Adderley U. Venous leg ulcers. BMJ Clin Evid. 2016;2016:1902. Published 2016 Jan 15. PMID: 26771825 PubMed 
  10. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest jan 2022).
  11. O'Donnell TF Jr., Passman MA, Marston WA, et al.; Society for Vascular Surgery; American Venous Forum. Management of venous leg ulcers: clinical practice guidelines of the Society for Vascular Surgery ® and the American Venous Forum. J Vasc Surg. 2014;60:3S-59S. PubMed 
  12. Gohel MS, Heatley F, Liu X, et al. A Randomized Trial of Early Endovenous Ablation in Venous Ulceration. N Engl J Med 2018. pmid:29688123 PubMed 
  13. Gohel MS, Mora J, Szigetei M, et al. Long-term Clinical and Cost-effectiveness of Early Endovenous Ablation in Venous Ulceration A Randomized Clinical Trial. JAMA Surg 2020; 155: 1113-21. pmid:32965493 PubMed 
  14. Raju S, Neglén P. Clinical practice. Chronic venous insufficiency and varicose veins. N Engl J Med 2009; 360: 2319-27. New England Journal of Medicine 
  15. O'Meara S, Cullum NA, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database Syst Rev, 11, 2012. CD000265. doi: 10.1002/14651858.CD000265.pub3 DOI 
  16. Nelson EA, Bell-Syer SEM. Compression for preventing recurrence of venous ulcers. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No.: CD002303. DOI: 10.1002/14651858.CD002303.pub3. DOI 
  17. Palfreyman S, Nelson EA, Michaels JA. Dressings for venous leg ulcers: systematic review and meta-analysis. BMJ 2007; 335: 244. British Medical Journal 
  18. Margolis DJ, Berlin JA, Strom BL. Which venous leg ulcers will heal with limb compression bandages? Am J Med 2000; 109-15-19.
  19. Shingler S, Robertson L, Boghossian S, Stewart M. Compression stockings for the initial treatment of varicose veins in patients without venous ulceration. Cochrane Database Syst Rev 2013; 12:CD008819. Cochrane (DOI) 
  20. Amsler F, Willenberg T, Blättler W. In search of optimal compression therapy for venous leg ulcers: a meta-analysis of studies comparing diverse bandages with specifically designed stockings. J Vasc Surg 2010; 51: 289. PubMed 
  21. Nelson EA, Hillman A, Thomas K. Intermittent pneumatic compression for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD001899. DOI: 10.1002/14651858.CD001899.pub4. DOI 
  22. Skiveren J, Bermark S, et al.: Klinisk retningslinje for rensning af akutte og kroniske sår: Sæbe, skyllevæsker og skylletryk. Sist revidert 31.07.2017. Center for kliniske retningslinjer, Aalborg Universitet. www.cfkr.dk 
  23. Samuel N, Carradice D, Wallace T, Smith GE, Chetter IC. Endovenous thermal ablation for healing venous ulcers and preventing recurrence. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD009494. DOI: 10.1002/14651858.CD009494.pub2. DOI 
  24. Carter MJ, Tingley-Kelley K, Warriner RA 3rd. Silver treatments and silver-impregnated dressing for the healing of leg wounds and ulcers: A systematic review and meta-analysis. J Am Acad Dermatol 2010; 63: 668-79. PubMed 
  25. Chaby G, Senet P, Vaneau M, et al. Dressings for acute and chronic wounds: a systematic review. Arch Dermatol 2007; 143: 1297-304. PubMed 
  26. Dumville JC, Worthy G, Bland JM, et al. Larval therapy for leg ulcers. BMJ 2009; 338: b773. BMJ (DOI) 
  27. Soares MO, Iglesias CP, Bland JM, et al. Cost effectiveness analysis of larval therapy for leg ulcers. BMJ 2009; 338: b825. BMJ (DOI) 
  28. Wilkinson EAJ. Oral zinc for arterial and venous leg ulcers. Cochrane Database of Syst Rev 2014, (9): Art. No.: CD001273. DOI: 10.1002/14651858.CD001273.pub3. DOI 
  29. Alguire PC, Scovell S. Overview and management of lower extremity chronic venous disease. UpToDate, last updated May 29, 2018. www.uptodate.com 
  30. Carroll C, Hummel S, Leaviss J, et al. Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniques versus surgery for varicose veins. Br J Surg 2014; 101:1040. PubMed 
  31. Barwell JR, Davies CE, Deacon J, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet 2004; 363: 1854-9. PubMed 
  32. Goel RR, Abidia A, Hardy SC. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2015 Feb 23;2:CD001097. PMID: 25702915 PubMed 
  33. Gohel MS, Barwell JR, Taylor M, et al. Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial. BMJ 2007; 335: 83. British Medical Journal 
  34. Mauck KF, Asi N, Undavalli C, et al. Systematic review and meta-analysis of surgical interventions versus conservative therapy for venous ulcers. J Vasc Surg. 2014. PMID: 24835693 PubMed 
  35. Robson MC, Cooper DM, Aslam R, et al. Guidelines for the treatment of venous ulcers. Wound Repair Regen 2006; 14: 649-62. PubMed 
  36. Hamnerius N, Wallin E, Svensson Å, et al. Fast and standardized skin grafting of leg wounds with a new technique. Medscape 2016. www.medscape.com 
  37. Jones JE, Nelson EA, Al-Hity A. Skin grafting for venous leg ulcers. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD001737. DOI: 10.1002/14651858.CD001737.pub4. DOI 
  38. Jull AB, Arroll B, Parag V, et al. Pentoxifylline for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2012; 12: CD001733. Cochrane (DOI) 
  39. Evangelista MTP, Casintahan MFA, Villafuerte LL. Simvastatin as a novel therapeutic agent for venous ulcers: a randomized, double-blind, placebo-controlled trial. Br J Dermatol 2014. doi:10.1111/bjd.12883 DOI 
  40. de Oliveira Carvalho PE, Magolbo NG, De Aquino RF, Weller CD. Oral aspirin for treating venous leg ulcers. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD009432. DOI: 10.1002/14651858.CD009432.pub2. DOI 
  41. Briggs M, Nelson EA, Martyn-St James M. Topical agents or dressings for pain in venous leg ulcers. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD001177. DOI: 10.1002/14651858.CD001177.pub3 DOI 
  42. Kranke P, Bennett MH, Martyn-St James M, et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database of Syst Rev 2015; 4. DOI: 10.1002/14651858.CD004123.pub4 DOI 
  43. O'Reilly D, Pasricha A, Campbell K, et al. Hyperbaric oxygen therapy for diabetic ulcers: systematic review and meta-analysis. Int J Technol Assess Health Care. 2013;29(3):269-81. doi: 10.1017/S0266462313000263. DOI 
  44. Liu R, Li L, Yang M, et al. Systematic review of the effectiveness of hyperbaric oxygenation therapy in the management of chronic diabetic foot ulcers. Mayo Clin Proc 2013 Feb;88(2): 166-75. doi: 10.1016/j.mayocp.2012.10.021. DOI 
  45. Stoekenbroek RM, Santema TB, Legemate DA, et al. Hyperbaric oxygen for the treatment of diabetic foot ulcers: a systematic review. Eur J Vasc Endovasc Surg. 2014 Jun;47(6):647-55. doi: 10.1016/j.ejvs.2014.03.005 DOI