What are Venous Ulcers?
A venous ulcer, or stasis ulcer, is a shallow wound that occurs when the leg veins don't return blood back toward the heart the way they should; this is called venous insufficiency.
Due to chronic venous insufficiency (CVI), the veins are no longer in the position to transport blood quickly from the legs to the heart. The blood pools and widens the veins. This so-called stasis ultimately damages the smallest blood vessels, or capillaries. These supply the cells with oxygen and nutrients and transport metabolic breakdown products away from the tissues. In turn, the damaged capillaries can no longer fulfill this function properly. First, the skin in the affected areas becomes sensitive, loses its elasticity, and grows hard. Eventually, the skin dies off and even the slightest, barely noticed injury turns into an open weeping wound.
Symptoms and Treatments
The open wound is typically very painful, and microorganisms that colonize the wound and its surroundings cause unpleasant odors. In many cases, those affected are afraid to go out and try to avoid contact with other people. The patients take on a protective posture due to the pain, and they barely move the affected leg at all. This lack of mobility, in turn, switches off the pump mechanism that transports the blood back in the direction of the heart and starts a vicious circle.
Efficient treatment of venous leg ulcer may include:
- Wound debridement and wound care: cleansing of the wound and care of the surrounding skin.
- Compression treatment is an element of wound care, even if many people believe that wound care is restricted to cleaning and dressing skin defects.
- Treatment of the underlying disease: in the case of venous leg ulcer, this means that the venous disease has to be treated. Medical compression stockings are used as disease-modifying treatment.
- Solutions to effectively prevent relapse of the diseases.
If CVI is left untreated, the skin surrounding the lower leg above the ankle may begin to itch or burn. Over time, the skin may become dry, flaky and darker in color. These skin changes are caused by high pressure in the veins from a reverse flow of blood and result in poor nutrition to the skin. Eventually, these skin changes can lead to a venous leg ulcer, which is very painful and difficult to heal.
The inside (medial) or outside (lateral) aspect of the calf or ankle are common locations for a venous leg ulcer to occur. A diagnostic ultrasound is essential to determine if the ulcer is caused by underlying venous insufficiency, and if it exists, an Endovenous ablation procedures and/or Sclerotherapy may be the answer.
Ulcerations to the lower extremities may also occur as a complication of poor arterial blood flow. This often manifests itself as an open sore on the toe and is a common complication of uncontrolled Diabetes. The cause of this type of ulcer is very different from a venous leg ulcer; therefore, treatment is best directed by a primary care physician.