Venous Leg Ulcer — SCE Dermatology MCQ

Correct answer: A — Reduction in oedema indicates compression is working and improving the venous haemodynamic environment; ulcer healing may lag behind oedema reduction

The correct answer is A: reduction in oedema indicates compression is working and improving the venous haemodynamic environment; ulcer healing may lag behind oedema reduction. Compression therapy works by reducing venous hypertension and limb oedema, improving the microcirculatory environment (oxygen and nutrient delivery, reduced capillary leakage) that underpins ulcer healing. A 4 cm fall in ankle circumference over 3 weeks is objective evidence the bandaging is achieving adequate sub-bandage pressure and effective oedema control, even though ulcer size has not yet changed. Ulcer bed healing is a slower process than fluid shift, so a static ulcer size in the early weeks of effective compression is expected and not itself a treatment failure. Regular reassessment of both limb circumference and ulcer dimensions is standard, with concern only warranted if ulcer size fails to reduce after a longer period (typically 4 to 6 weeks) of confirmed effective compression.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions