At Dekalb Vein Center, we see many patients with venous leg ulcers. This painful condition can greatly deplete a person’s quality of life. Some patients cope with it for years, not knowing that more effective treatments are available.
What are venous leg ulcers?
Venous leg ulcers are chronic, open wounds that typically occur on the lower leg or ankle and are very slow to heal. They can last anywhere from a few weeks to several years and may never fully heal at all. Ulcers that do heal often come back again and again.
What causes venous ulcers?
Venous leg ulcers are caused by a condition called venous insufficiency.
Healthy veins regulate blood flow using tiny, one-way valves that keep your blood flowing towards your heart. In patients with venous insufficiency, the valves have become weakened or damaged so that blood refluxes (flows backwards) and pools inside the vein.
Over time, pooled blood increases pressure in the vein and fluid begins to seep out into surrounding tissues. This is known as fluid retention or edema. Excess fluid irritates the dermal (skin) tissue causing inflammation and eventual breakdown. Broken down tissue results in an ulcer.
What do venous ulcers look like?
Venous leg ulcers are typically large, shallow sores with uneven edges, though a patient may also present with one or more smaller sores. They can occur anywhere but are most common on the inside of the lower leg near the ankle. The skin around the ulcer is often discolored and thickened. The leg itself will usually be swollen. The ulcer may be itchy, painful, and drain or weep a lot.
Who gets venous leg ulcers?
Anyone can get a venous leg ulcer. However, most of the patients we see are older and have underlying medical conditions such as hypertension (high blood pressure) or obesity. Women are also more likely than men to develop them.
One of the biggest risk factors for developing a venous leg ulcer is having varicose veins; though, not everyone with varicose veins will develop leg ulcers nor does everyone with leg ulcers have visible varicose veins.
Other risk factors for venous leg ulcers include:
- Being a woman over the age of 40
- Leading a sedentary lifestyle
- Having a history of smoking
- Having a history of blood clots
- Being overweight
- Having high blood pressure
- Being diabetic
- Being pregnant
What can venous ulcers lead to?
If not properly cared for, a venous leg ulcer can become infected. The infection may present as cellulitis, where the skin and subcutaneous tissues around the wound become inflamed, warm, painful, and tender to the touch.
In the worst cases, infection can progress to septicemia (infection of the blood) or osteomyelitis (infection of the bone), which would then require hospitalization and possible amputation. However, this is not common and can usually be avoided with proper wound care. That’s why it’s very important to see your doctor for your venous ulcer and follow all their instructions.
Can you prevent venous ulcers?
There is no guaranteed way to prevent venous ulcers. You can, however, greatly lower your risk by taking good care of yourself.
- Avoid smoking
- Maintain a healthy weight
- Get regular exercise
- Take regular breaks to move if you sit at work
Compression stocking can also help reduce swelling and prevent blood from pooling in the legs.
How are venous ulcers treated?
The most commonly prescribed treatment for venous ulcers is compression. Your doctor may bind your wound in a special pressure bandage called an unna boot. Or they may dress the wound in sterile bandages and ask you to wear compression stockings. This compression helps keep blood from pooling in the veins so the ulcer can heal.
It’s important to keep a venous ulcer clean and dry to prevent infection. If infection does occur you will be prescribed with appropriate antibiotics. Be sure to take all medication as prescribed.
The underlying circulatory issues that are causing the ulcer also need to be addressed.
If you don’t want your leg ulcers to come back, then the underlying venus insufficiency needs to be treated, as well. This is done with an outpatient procedure called venous closure. This is a minimally invasive procedure that stops blood from pooling in your legs. This helps existing ulcers heal and prevents future ulcers from forming. There are several methods of venous venous closure available, including:
- Ultrasound-guided sclerotherapy
- Radiofrequency or laser ablation (closure)
- Vein glue
If you (or someone you know) are suffering from venous leg ulcers, feel free to contact our office to talk to a vein specialist about your treatment options.
