Learn about venous stasis ulcers and how our vein doctors can help you.
What are venous stasis ulcers?
Venous stasis ulcers are open sores in the lower leg caused by vein disease. They are one of the most troublesome complications of varicose vein disease. They typically occur between the knee and ankle, most commonly around the ankle.
When varicose veins occur, there is impairment of the normal blood flow within the leg. The valves within these veins are no longer able to prevent blood from moving up in the leg like it is suppose to. Because of the dysfunction involving these valves, blood gets ‘backed up’ or ‘stuck’ in the veins. This causes the pressure within the veins to increase. The higher pressure will, over time, cause progressive damage to the surrounding veins, skin, and soft tissue of the lower leg.
Prior to the ulcer developing, the skin in the surrounding area may become discolored. Sometimes it becomes red, brown, or purple compared to the surrounding skin. At times, the area becomes painful, itchy, or irritated, and it may swell. Other times, the skin in the area will contract and become harder or take on a leathery appearance. Overtime, the skin in the area starts to break down and opens (ulcerates). These ulcers are usually shallow and they get bigger over time. Occasionally, if there are varicosities within the ulcer, they can bleed quite a bit. Even with vein treatment, these ulcers can last months to years before healing. Once they heal, the skin in the area is weak and they are very likely to re-ulcerate in the future.
What are the symptoms of ulcers?
Ulcers may or may not be painful. There is generally some swelling of the leg and around the wound. They may feel itchy or they may burn. Often the skin in the surrounding area is discolored (red or brown). There may be a rash in the area (venous eczema) or elsewhere on the leg. The ulcer, itself, may be dry with a black or dark ‘scab’ appearance, or it may have a discharge or thick yellow coating over the raw looking base of the ulcer.
Are there other possible causes of ulcers?
Yes, there are several types of ulcers caused by different medical issues. The three most common ulcers are:
- venous ulcers – due to chronic venous stasis and/or varicose vein disease
- diabetic ulcers – associated with poor healing due to with high sugar levels and diabetes
- arterial ulcers – due to poor arterial flow to the skin and soft tissues, often associated with peripheral artery disease (PAD)
The differentiation of these ulcers is made by a combination of evaluations, including the history and physical examination done by the clinician, lab testing/blood work as needed, and evaluation of the arterial and venous systems using specialized studies.
At the Center for Advanced Vein Care, Dr. Stiller and her staff will work together to determine the cause of the ulcer. She has received specific training in the diagnosis and care of venous ulcers and will develop an individualized treatment program for each case based on the patient’s health, medical conditions, and ability to care for the wound. The goal is to relieve the pain, speed recovery, and heal the wound.
Treatment options for all ulcers may include:
- antibiotics, if an infection is present
- topical wound care therapy
- compression wraps or stockings specific for ulcer care
- treatment for the underlying cause of the wound
- rarely, referral for plastic surgery may be required for large ulcers
One of the most common and effective treatments for venous ulcers is the use of compression to minimize edema or swelling. Compression treatments include wearing properly fitted Class II or higher compression stockings or multi-layer compression wraps. The type of compression treatment prescribed is determined by your vein doctor based on many things, including the characteristics of the ulcer, amount of drainage from the ulcer, and the ability of the patient to participate in caring for the wound.
How can venous ulcers be prevented?
The BEST prevention for venous ulcers is to treat vein disease, such as varicose veins, BEFORE an ulcer develops.
- IF you have varicose veins, get them evaluated and treated before an ulcer develops.
- If you have a history of blood clots (DVT) in your legs, wear properly fitted compression stockings or wraps to prevent post thrombotic syndrome (PTS).
- Exercise, maintain a healthy weight, avoid sitting and standing for long periods of time, wear low heeled shoes
- If you start to see skin changes as described above, or if a small sore or ulcer appears, see a vein specialist as soon as possible
The treatment for venous ulcers is difficult. They often require weeks to months of professional care before the ulcer begins to heal. The recurrence rate for venous ulcers is high, even with treatment for the underlying cause of the ulcer. Therefore, it is crucial to come into our vein clinic for treatment as early as possible. If you are experiencing varicose veins, schedule a free screening with a vein doctor today.