Abstract

Venous ulceration of the lower leg is a common and distressing problem which can be very difficult to treat. It is usually caused by a failure of the calf muscle pump which leads to venous hypertension. When prolonged, this can result in capillary proliferation and pericapillary deposition of fibrin¹ which probably impairs oxygen diffusion.² The skin becomes eczematous, pigmented and painfully indurated (so-called lipodermatosclerosis), and ulceration may follow. Fibrinolytic activity in blood and tissue is also impaired in patients with venous hypertension.³ A drug which could promote fibrinolysis might therefore help. The anabolic steroid stanozolol (Stromba - Sterling) enhances fibrinolysis; the manufacturer claims that it prevents the development of new ulcers and reduces the incidence of re-ulceration. Does it really do this?