Venous Ulcerations
What is it?
Venous ulcerations are open sores,
usually on the legs. These sores occur as
a complication of poor blood circulation
from the legs to the heart.
Who gets it?
The chances of developing venous
ulcerations increase with age. Those with
a history of venous insufficiency, a
condition where damage to the veins causes
blood to pool in the veins of the lower
legs, are most likely to develop venous
ulcerations. Paraplegics are also more
likely to develop venous ulcerations
because the calf muscle is immobile.
What causes it?
The most common cause of venous
ulcerations is venous insufficiency.
Venous insufficiency occurs when the
valves in the veins become damaged and
allow the blood to leak backward, instead
of upward to the heart. Varicose veins can
damage the valves. Or, damage can occur
when there is a problem with the calf
muscle, so the blood isn’t being pushed
upward. Chronic venous insufficiency can
also be caused by a blockage in a vein,
such as a blood clot. As the blood begins
to pool in the veins, it creates pressure
and swelling in the legs. Eventually, the
capillaries burst under the high pressure,
releasing red blood cells and giving that
area of the skin a reddish-brown
discoloration. The discolored skin is
easily broken by a scratch or bump. This
open skin then becomes an ulcer.
What are the symptoms?
Venous ulcerations are often preceded
by red, itchy patches on the skin. These
patches are easily broken open, and the
ulcers that result can become infected. An
infected venous ulcer will ooze pus and
have a foul-smelling discharge. If the
infection spreads to the surrounding
tissue, the patient develops a condition
called cellulitis.
How is it diagnosed?
To diagnose venous ulcerations, your
doctor will take your medical history,
paying careful attention to any history of
varicose veins, thrombophlebitis, or any
other condition that causes venous
insufficiency. He or she will carefully
examine your legs for swelling (edema),
varicose veins, patches of red and scaly
skin, and areas of reddish-brown
discoloration. The doctor may also order a
procedure called duplex scanning, which is
a painless ultrasound examination of the
leg veins.
What is the treatment?
To treat venous ulcerations, you must
treat the underlying cause, which is
venous insufficiency. An important way to
prevent ulcerations is to wear compression
stockings, which squeeze the veins and
keep blood flowing so it is more difficult
for blood clots to form and swelling to
occur. It is extremely important to keep
the area clean and dry. Venous ulcers are
usually treated with a metronidazole gel
to help prevent bacterial growth and
reduce odor. A steroid ointment may also
be used to treat itching. The ulcers are
covered with special dressings, which need
to be changed regularly. With this
treatment, the ulcers usually heal within
weeks or months. Infected ulcers and
cellulitis must be treated with oral
antibiotics.
Self-care tips
If you have been diagnosed with venous
ulcerations caused by venous
insufficiency, keep your feet raised above
the level of your heart whenever you are
sitting or lying down, and avoid any long
periods of sitting or standing. If you
wear elastic stockings, be sure to take
them off each day to wash and dry them,
and to clean and check your skin and give
it some air. Make sure the stockings fit
so there is no bunching. Elastic stockings
that fit poorly will actually make your
condition worse by blocking blood flow in
the area where they have bunched up. Also
keep your skin moisturized so that it
doesn’t flake or crack easily.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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