Venous Insufficiency Leg Ulcers And Venous Ulcerations
Understanding Venous Leg Ulcers
What is a venous leg ulcer / venous stasis ulcer
Venous ulcers, commonly referred to as venous stasis ulcers, are a form of vascular ulcer and are caused by problems with blood circulation within your body. Vascular ulcers can form anywhere on the body, but are primarily prevalent on the lower legs and feet. A form of chronic wound, vascular ulcers can take a very long time to heal, if at all, and usually require specialized medical treatment. Vascular ulcers can develop from either poor circulation within your arteries (arterial ulcers), or from poor circulation within your veins (venous ulcers). The most common type of vascular ulcer is a venous ulcer, and they represent approximately 70-90% of all chronic wounds.
The relationship between venous leg ulcers and chronic venous insufficiency
Generally speaking, in a properly functioning circulatory system, oxygenated blood is pumped by the heart through arteries (the arterial system) to cells, where oxygen is exchanged for carbon dioxide. The carbon dioxide and other waste products are then transported through veins (the venous system) and back to the heart, where they are filtered out by the lungs and kidneys. If the circulatory system doesn't function properly, oxygen and nutrients will not be delivered to organs and tissues, while carbon dioxide and waste will not be removed. A common disease which may negatively impact the circulatory system is venous disease, and specifically venous insufficiency. Venous insufficiency is a condition in which the veins do not function properly and have problems sending blood from the legs back to the heart.
Venous insufficiency is a broad term that describes a condition where the leg veins are unable to effectively pump blood back to the heart. Venous insufficiency can range from being mild to severe, and if left untreated, it may progress to chronic venous insufficiency (CVI). Chronic venous insufficiency represents a more serious and longer-lasting version of venous insufficiency, and carries with it the potential for greater complications.
Chronic venous insufficiency 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. These venous ulcers often occur on the legs and near the ankle and are therefore recognized 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 heals. Venous ulcers can worsen quickly, putting you at risk for additional complications that can cause you to lose your limb if undiagnosed and left untreated.
Other contributing factors that cause venous leg ulcers
While chronic venous ulcers have a greater likelihood of occurrence as we age, other contributing causes for venous ulcers include:
- High blood pressure (hypertension), which damages blood vessel walls.
- Venous obstruction (a vein blockage) that is oftentimes caused by blood clots.
- Venous reflux, when blood flows backward through weak or damaged valves.
In addition to health-related factors, these lifestyle-related factors can also increase the chance of a venous ulcer developing:
- Sedentary lifestyle or lack of mobility
- Prolonged standing, and especially in one spot
- Diabetes
- Poor eating habits and obesity
- Smoking and using tobacco products
- Injuries, such as bone fractures, burns or muscle injuries may damage nearby blood vessels, which lead to circulation problems
- Family history of vascular issues
Symptons of venous leg ulcer development and formation
Symptoms that a venous leg ulcer may be forming include:
- Development of varicose veins
- Hardening or discoloration of the surrounding skin (usually red, purple or brown)
- Cramping, heaviness and a dull, painful ache
- Swelling (edema)
- Tingling and itching in the affected area (stasis dermatitis)
In addition to a visible shallow wound with irregular borders and uneven edges, symptoms of having a venous stasis ulcer include:
- A wound site which has formed near the ankle
- The area around the ulcer may be shiny and the skin may look stretched thin
- The skin in the area of the wound is warmer than the skin further away
- The visible wound may be red and have a yellow covering
- Painful and may bleed
- Foul odor emitting from the wound site
- Pus or other fluid that oozes from the sore
Long term consequences of having a venous leg ulcer
Venous ulcers can be very painful, and depending on the location of the ulcer, they can prevent you from performing normal daily activities. As your mobility and activity level decreases, so does your blood circulation, which in turn can make the venous ulcer even worse.
Having a venous stasis ulcer also increases the risk of developing an infection. Your skin is a protective barrier that keeps germs out, and an open wound in the form of a venous ulcer is a way that external bacteria and germs can bypass that barrier and enter your body. If the wound does become infected and the infection isn't treated, it can spread and lead to an extremely deadly condition called sepsis. Sepsis is when your body reacts so strongly to a major infection that your immune system begins to damage different parts of your body itself. Untreated infections can also cause cells in nearby tissue to die. This can cause gangrene, which will spread and ultimately be fatal if not treated. Even in the absence of infection, the lack of sufficient blood flow which caused the venous ulcer in the first place can also cause the cells in nearby tissue to die, leading to gangrene.
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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 treating venous insufficiency venous ulcerations.
Click here to read frequently asked questions about chronic venous insufficiency.