Venous Ulcers

Venous ulcers, also known as venous stasis ulcers or venous leg ulcers, are open sores that usually occur in the lower extremities, particularly on the inner part of the leg, just above the ankle. These ulcers are caused by improper functioning of the veins, specifically the valves. When these valves don’t work as they should, blood can pool in the legs, leading to increased pressure and subsequent ulcer formation. They are one of the most common chronic wounds and can be a source of significant morbidity if not treated promptly and appropriately.

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Treatment Options

  • Compression stockings: This improves blood flow, reduces swelling, and improves symptoms. Compression increases the external pressure, assisting the veins in pushing blood back up to the heart.
  • VenaSeal: This procedure closes the vein by sealing it with a combination of adhesive and external compression.
  • ClosureFast: This method uses radiofrequency energy to heat the walls of the vein, causing it to collapse and seal shut.
  • Wound Dressings: These keep the ulcer clean and free from infection. Different types of dressings, such as hydrocolloids, foam, and alginate, can be used based on the wound’s condition.

Symptoms

  • Open sore: Typically located on the inner leg, just above the ankle.
  • Size and depth: Ulcers can vary in size and can be shallow or deep.
  • Pain: Some ulcers can be painful, especially when infected.
  • Swelling: Around the affected area.
  • Discoloration: The skin around the ulcer may appear dark red, brown, or purple.
  • Itchy, flaky skin: The skin around the ulcer can become dry and flaky.
  • Discharge: The ulcer may produce a clear, yellowish fluid.

Causes

  • Chronic Venous Insufficiency (CVI): This is the most common cause, where the leg veins struggle to return blood back to the heart, leading to pooling and increased pressure in the veins.
  • Blood clots: Past or current deep vein thrombosis (DVT) can damage vein valves and increase the risk of ulcers.
  • Varicose veins: Enlarged, superficial veins can increase the risk of venous ulcers.
  • Trauma: An injury to the leg can sometimes trigger an ulcer in a person with compromised venous circulation.
  • Infection: Can sometimes lead to the development or worsening of ulcers.
  • Other factors: Obesity, lack of movement or prolonged standing, and a history of leg swelling can all contribute to the development of venous ulcers.

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Anwar Mack, MD

Double Board Certified Physician