Venous statis ulcers, otherwise known as venous ulcers, are non-healing or slow-healing wounds which form as a result of the backward flow of blood in the lower extremities. Venous stasis ulcers can be the result of vein disorders such as deep vein thrombosis (DVT) or clotting disorders or are symptomatic of chronic venous insufficiency (CVI).
Talk to your doctor about the possibility of venous stasis ulcer if you have a wound on your leg or ankle which does not heal, or is slow to heal (over 4-6 weeks). After diagnosing your condition, your doctor can devise a treatment plan to address the underlying issues causing the ulcer. Treatments may include using compression garments, various wound dressings, topical or oral medications, surgery or a combination of these to alleviate your pain and help your ulcers heal.
What are venous stasis ulcers?
Venous stasis ulcers are found primarily found below the knee, and sometimes around the ankle. The base of the wound is usually red and covered in yellow fibrous tissue. There may be a lot of yellow or green drainage from the ulcer, especially if wound is infected. The ulcer is often an irregular shape, and the surrounding skin is often inflamed and swollen.
As a symptom of venous disorder, venous stasis ulcers often accompany other symptoms such as varicose veins (twisted, swollen veins on the skin’s surface), hyperpigmentation (discoloration or darkening of the skin), and lipodermatosclerosis (thickening of the skin).
Treatment of venous stasis ulcers
Your doctor will devise a treatment plan designed to address the underlying causes of your ulcer, reduce swelling and inflammation, treat the surrounding skin, encourage healing and prevent further ulcers from forming.
- Compression therapy is key to treating venous ulcers. Compression treatments alleviate leg swelling and encourage circulation. It is administered in the form of compression bandages, compression garments, or gauze wrappings.
- Compression garments include pantyhose-like garments, or above or below-the-knee knee highs. Four-layer bandage compression treatments have been traditionally given to patients with venous stasis ulcers. A recently published study in Nursing Times has shown that in some cases, two-layer compression stockings can be just as effective a four-layer compression bandages in venous ulcer treatment. Your doctor will recommend the compression therapy most suitable for your wounds.
Medication can be used in conjunction with other therapies to treat venous ulcers.
- Oral or topical antibiotics can be used to treat infections both in and around the ulcer site.
- Anti-clotting or anti-platelet medications can be administered to keep blood flowing and prevent clotting.
Medical dressings come into direct contact with a wound, and are designed to prevent infection, encourage healing and alleviate discomfort.
Your doctor will give you instructions for caring for your wounds at home. You will also be encouraged to adopt healthy lifestyle choices, which aid in the healing process and could prevent further wound development. Regular exercise, especially walking, is beneficial for patients with venous ulcers. Likewise, putting your feet up can help vein circulation. Quitting smoking, eating a healthy diet and maintaining a healthy weight will help keep your body in top form and speed the healing process. Managing chronic conditions such as diabetes and CVI will help prevent ulcers from forming.
Medical procedures for venous stasis ulcers
- Surgery which helps repair valve deficiency, vein weakness or blood clots can help venous ulcers to heal by addressing the underlying issues causing them.
- Sclerotherapy uses chemical injections to destroy a problem vein.
- Laser therapy uses lasers and ablation uses heat to destroy problem veins.
- Problem veins can be removed by ligation (tying off veins) and stripping (removing a section of vein through two small incisions), or phlebectomy (using a special hook to remove a vein).
- Valve repair is a procedure which repairs valves to alleviate backwards flow of blood.
Prognosis for venous stasis ulcers
Venous stasis ulcers tend to recur and can be difficult to treat. If you suspect you have a venous ulcer, see your doctor as soon as possible. Healing smaller ulcers is easier than waiting until the ulcer become larger, infected and harder to treat. Working closely with your doctor, complying with the care plan and following up with consistent doctor visits will help ensure the success of your treatment plan.
Causes of venous stasis ulcers
Venous stasis ulcers are wounds which develop from venous stasis, which is a stasis (static, unmoving) or pooling of the blood. Several factors may lead blood to backtrack into the legs, and blood to pool in the veins.
Weakened veins and faulty valves characteristic of DVI can lead to venous reflux (backtracking of blood) and venous stasis. Over time, circulatory impairment can change and damage the skin and lead to the development of ulcers. Deep vein thrombosis occurs when blood clots form in deep veins. As with CVI, circulatory impairment as a result of DVT can lead to the development of ulcers. Similarly, blood clotting disorders can also contribute to ulcer formation.
Diagnosing of venous stasis ulcers
In order to diagnose your condition, your doctor will take a complete medical history. Be sure to tell your doctor about any past injuries or surgery, or if you have diabetes or DVT. Your doctor will do a thorough physical exam, taking special note of leg and ankle swelling, varicose veins, hyperpigmentation, and lipodermatosclerosis. Vascular tests such as the duplex ultrasound will examine how well blood flows through your veins. X-rays or MRI may also be helpful in diagnosing vein issues which may contribute to ulcer formation.
Are you at risk for venous stasis ulcers?
You may be at risk for venous stasis ulcers if you have varicose veins, DVT, or have a history of leg and ankle swelling.
Reviewed February 10, 2017