Chronic Venous Insufficiency And Venous Ulcerations: Management And Treatment

Chronic Venous Insufficiency And Venous Ulcerations: Managing and Treating These Conditions

Chronic venous insufficiency (CVI) is a leading cause of venous ulcers, and specifically venous leg ulcers. Venous ulcers, also known as venous stasis ulcers, occur when oxygen-poor blood can’t flow from your extremities back to your heart and instead, it pools, creating pressure in your veins. The pooling of this blood damages skin tissue and leads to the development of an ulcer as the blood vessels begin to leak and ultimately burst. Venous ulcers often occur on the legs and near the ankle and are therefore recognized, or are referred to as venous leg ulcers. Being a chronic wound, a venous ulcer is a wound that can take several months to heal and in severe cases, the ulcer never actually heals. Venous ulcers can worsen quickly, putting you at risk for additional complications that can cause you to lose your limb if it is undiagnosed and left untreated. By understanding the causes of and treatment for chronic venous insufficiency, you will be better prepared to prevent the development of venous ulcerations.

Causes Of Chronic Venous Insufficiency

As the human body ages, we naturally become more susceptible to the development of venous insufficiency. However, external factors such as lifestyle influences can play a significant role in aiding in the development of venous disease. Some of the more common causes of venous insufficiency include:

• Weakening of vein valves due to old age
• Long periods of physical inactivity, or a sedentary lifestyle
• Unhealthy eating habits
• Obesity and an unhealthy body mass index (BMI)
• Smoking and use of tobacco products
• Previous history of blood clots
• Fatigued muscles
• Pregnancy

Prevention Of Chronic Venous Insufficiency And Venous Ulcerations

There is no full-proof way to prevent either venous insufficiency or chronic venous insufficiency, and once the underlying damage to the veins in your legs occurs it cannot be fully reversed. However, there are certain steps that you can take to help prevent the development of venous disease. A core element towards preventing the development of venous insufficiency and chronic venous insufficiency generally includes making the following lifestyle changes or modifications to help remove or alleviate the conditions which lead to the formation of venous disease:

• Leg elevation: Lifting your legs above the level of your heart for 30 minutes or longer at least three times per day can help reduce pressure in your leg veins.
• Exercise: Walking and other forms of exercise can help blood flow better in your leg veins. Each time you take a step, your calf muscle squeezes and helps your veins pump blood back up to your heart. This “calf muscle pump” is known as your “second heart.” It helps blood in your legs defy gravity, and it’s vital for your circulation. By making your calf muscles stronger it can help improve your circulation and blood flow.
• Weight management: Extra weight can put pressure on your veins and damage the valves, therefore it is important to maintain a healthy weight. If you are suffering from CVI, you should consider working with a health care provider or nutritionist to develop a healthy and manageable plan for achieving weight loss and weight management.
• Smoking and tobacco use:: Smoking can contribute to the development of venous insufficiency as it can constrict blood vessels, trigger inflammation in the veins, damaging the lining and vein walls, while weakening their valves. Therefore, you should consider the effects of smoking and the use of tobacco products on your vein health.

Symptoms Of Chronic Venous Insufficiency

As venous disease begins to form, symptoms which indicate the presence of this condition will begin to appear. You should remain cognizant of these symptoms and if you suspect that you may have venous disease, you should immediately contact your healthcare provider for a professional medical diagnosis so that appropriate treatment can begin. By properly recognizing and diagnosing the development of venous disease, you will be better able to treat the condition to prevent it from becoming more severe, to include the development of venous ulcers. Some of the symptoms of having venous insufficiency include:

• Swelling (edema) in your feet, ankles or legs
• Heaviness, aching or cramping in your legs
• Pain that worsens with standing and improves with elevation
• Changes in the skin, including discoloration, itching, hardening or scaling
• Development of varicose veins

If these initial symptoms of venous insufficiency appear and go undiagnosed or are left untreated, they may worsen over time and progress into a more serious form of venous disease such as chronic venous insufficiency, including venous ulcerations, which are open sores on the exterior of the feet, ankles and legs.

Treatment Of Chronic Venous Insufficiency And Venous Ulcerations

There is no full-proof way to prevent either venous insufficiency or chronic venous insufficiency, and once the underlying damage to the veins in your legs occurs it cannot be fully reversed. However, with proper treatment these chronic diseases can be effectively treated and managed. While some causes of venous disease, such as old age, are unavoidable, there are certain steps that you can take which will help prevent the development chronic venous insufficiency.

If venous disease (venous insufficiency or chronic venous insufficiency) should develop, there are several methods for treating these conditions. The method and manner of treatment will likely depend on the severity of the condition as well as your personal circumstances. You should obviously consult with your healthcare provider to properly diagnose your condition and implement the proper method of treatment. Generally speaking the primary means of treating venous insufficiency and chronic venous insufficiency include:

• Compression Therapy

Generally, compression therapy is the primary and desired method for treating CVI. Using compression therapy helps reduce the swelling and discomfort that is present in your legs. The compression will help your veins “push” the blood back through the venous system to the heart and prevent it from pooling. Compression may be achieve through the use of short stretch compression bandages, compression stockings or compression wraps. Generally these compression therapy products may be purchased without a prescription. If a higher level or more complex method of compression is needed to treat your particular case of CVI, you should consult with your medical professional to ensure that you will have an effective and safe treatment plan to follow.

• Medications
Some of the medications which may be prescribed to treat CVI include antibiotics and anticoagulants (blood thinners). The antibiotics can be used to clear skin infections or ulcers caused by CVI, while the anticoagulants can treat existing blood clots and prevent future blood clots from forming. While the use of medications can address the side affects of having CVI, they won’t treat the primary or underlying causes of the disease.

Using a multilayer compression bandage or a medicated wrap known as an Unna boot combine compression along with medication. A multilayer compression bandage combines compression bandages with antimicrobial wound dressings, while the Unna boot is a compression bandage that is impregnated with a zinc oxide paste that forms a semi-rigid medicated bandage which is useful for treating chronic wounds.

• Nonsurgical treatment

Nonsurgical treatments for CVI include:

• Sclerotherapy, is a minimally invasive procedure where a foam or liquid solution is injected into your spider vein or varicose vein, which causes the vein to collapse or disappear.
• Endovenous thermal ablation targets varicose veins through the use of a laser or high-frequency radio waves to create intense heat. This heat closes up the diseased vein but leaves it in place, preventing bleeding or bruising.
• Surgical treatment

Surgical treatments for CVI include:

• Ligation and stripping, which are two procedures are often performed together. With vein ligation, the problem veins are cut and tied off, while stripping is the surgical removal of larger veins through two small incisions.
• Microincision/ambulatory phlebectomy is another minimally invasive procedure that uses a phlebectomy hook to remove varicose veins near the skin’s surface.
• Subfascial endoscopic perforator surgery (SEPS) is a minimally invasive procedure that targets your perforating veins above your ankle.
• Vein bypass is similar to heart bypass surgery, where part of a healthy vein taken from somewhere else in your body is used to reroute blood around your damaged vein.

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Additional Resources For Understanding Venous Disease

Click here to read more about understanding venous insufficiency.

Click here to read more about chronic venous insufficiency.

Click here to read more about venous insufficiency ulcers and venous ulcerations.

Click here to read frequently asked questions about chronic venous insufficiency.