When venous leg ulcers emerge, they are found in lower extremities near the inside of the ankle. They typically have irregular borders with at least partial skin loss and may release yellow or greenish drainage. The skin surrounding the ulcer is commonly inflamed, darker, and may be firm to the touch. Many of these wounds are tremendously painful while others have little to no discomfort. The accompanying degree of inflammation may play a role in pain the lesions. Additional symptoms frequently include leg aching, heaviness, swelling, throbbing and leg cramping, and these symptoms increase when sitting or standing for long periods of time and decrease with leg elevation.
The cause of venous stasis ulcers is due to a complex combination of high venous pressure from dilated veins, secondary inflammation, and minor trauma. The smallest scratch fails to heal and grows into an open sore. Risk factors for venous stasis ulcers include; presence of varicose veins, personal history of leg ulcer or deep venous thrombosis, a family history of stasis ulcers, impaired calf pump from a variety of conditions including cerebral palsy or ankle fusion.
The current standard of care in managing the ulcer involves local wound care, compression therapy, ambulation (walking), and treatment of the underlying venous disease. Compression therapy is mandatory in stasis ulcers, and may involve leg wraps, interlocking bandages, or compression stockings. Treatment of the underlying venous disease serves to enhance the speed of ulcer healing and is scientifically proven to reduce the risk of recurrence which can be as high as 30%/ year if the offending veins are left untreated.
