Understanding Venous Ulcerations

What Are Venous Ulcers and Venous Ulcerations

The most common type of vascular ulcer is a venous ulcer, and they represent approximately 70-90% of all chronic wounds. Vascular ulcers can develop from either poor circulation within your arteries (arterial ulcers), or from poor circulation within your veins (venous ulcers). 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. Venous ulcers can form anywhere on the body, but are primarily prevalent on the lower legs and feet. A form of chronic wound, venous stasis ulcers can take a very long time to heal, if at all, and usually require specialized medical treatment.

What Causes A Venous Leg Ulcer

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. 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.

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

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.

How Are Venous Leg Ulcers Treated

Categorized as a chronic wound, a venous leg ulcer often requires specialized medical care and treatment to properly and effectively manage the wound healing process. In addition to applying methods that directly facilitate the healing process of the wound itself, treatment of a chronic wound will likely involve addressing the underlying causes of the wound. Chronic wound treatment can broadly be categorized as involving:

Debridement of the wound (removing dead or infected tissue at the wound site).
Use and application of an appropriate wound dressing to maintain a moist wound healing environment and protect the wound site.
Infection control (use of antibiotics if necessary).
Addressing and managing underlying conditions which contributed to the chronic wound, such as diabetes or poor circulation.

The use of compression therapy is a well-established and commonly practiced primary method for treating venous-related chronic wounds. The use of compression involves the application of controlled pressure to the affected wound area, which helps promote healing by improving circulation and blood flow, reducing inflammation and swelling and helping to control pain. This compression is typically applied through the use of compression bandages, compression wraps or compression stockings.

While it is absolutely critical to seek the advice of your healthcare provider to help treat and manage your chronic wound, there are steps that you can take individually to help facilitate the wound healing process. These self-care steps for helping to manage chronic wounds include:

Maintain a balanced and healthy diet, as proper nutrition can provide your body with what it needs to heal from a chronic wound.
Refrain from smoking as the effects of smoking impairs the body’s natural healing process.
Staying active will help your circulation and improve blood flow, contributing to your overall general health.
Stay hydrated - drinking plenty of water helps transport nutrients within and removes waste from your body, helping it heal from chronic wounds.
Keep pressure off and elevate affected wound sites which will better allow them to heal.
Follow proper wound care steps as prescribed by your healthcare provider.
Manage other chronic medical conditions that you might have:

For diabetes, maintain blood sugar levels, wash and moisturize your feet daily, keep pressure off of your feet and wear diabetic socks.
With chronic venous insufficiency and varicose veins, wear compression socks or compression wraps that provide needed compression to help contain swelling and improve circulation and blood flow.

Please note that you should consult with your healthcare provider for a specific plan of self-care in helping to manage your particular medical condition.