Table of ContentsView AllTable of ContentsVenous Ulcer FormationSignsTreatmentDressing the WoundRisks and ComplicationsVenous Ulcer Not Healing
Table of ContentsView All
View All
Table of Contents
Venous Ulcer Formation
Signs
Treatment
Dressing the Wound
Risks and Complications
Venous Ulcer Not Healing
Venous ulcers are slow-healing wounds or sores that typically form in the lower leg’s gaiter zone. The leg’s gaiter area is a few inches below the knee and above the ankle. The most common location for venous ulcers is on the inner calf, just above themedial malleolus, which is the bony ankle bump on the southernmost part of thetibia.
Without venous ulcer treatment, theseopen soresoften fail to heal within two weeks due to poorblood flowand vein issues that inhibit deoxygenated blood in the lower legs from returning to the heart.
Most venous leg ulcers (VLUs) are associated with chronicvenous insufficiency, which can cause stasis (diminished blood flow) andstasis dermatitison the lower extremities.When stasis and blood pooling cause sores on legs, the leg sore is called avenous stasis ulcer. Venous leg ulcers are also correlated with varicose veins anddeep vein thrombosis, which creates blockages in leg veins.
This article discusses how to locate and identify a venous leg ulcer, venous ulcer symptoms, prompt treatment options that can improve blood flow from the legs to the heart, and other ways to help these slow-to-heal wounds get better faster and not recur.
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Veins, Blood, and Venous Ulcer Formation
How to Identify Leg or Ankle Venous Ulcers
Early symptoms of venous ulcers include swelling, itching, tingling, and pain in the affected area. The skin around the ulcer can become discolored or hardened.
When identifying a venous leg ulcer, one telltale sign is having a lower calf muscle that looks like an upside-down champagne bottle or inverted bowling pin. In medical terms, a swollen lower leg that resembles an upturned bowling pin or bottom-up champagne bottle is calledlipodermatosclerosis.
What Are Venous Ulcer Symptoms?
Venous ulcer symptoms often overlap with symptoms of poor lower leg blood flow and chronic venous disease. These include:
Varicose Veins Are Different from Venous Ulcers
Treatment to Heal Venous Ulcers
In addition to wound care, the most important part of prompt treatment for venous ulcers is addressing the underlying problem that’s preventing healthy blood circulation back up to the heart from the lower legs. It’s usually venous insufficiency or chronic venous disease.
As part of compression therapy,compression stockingsare the gold standard treatment used to mitigate the root cause of venous ulcers and promote healing. Elevating the legs above the heart while lying down also helps venous blood flow from the lower limbs back to the heart.
Walking, lower-body exercises, and physical therapy can all activate the calf muscle, which promotes venous blood flow from the legs back to the heart as part of a treatment to heal venous ulcers.
Longer-term treatments for venous insufficiency and VLUs may include vascular surgery or venousablation, which closes off damaged veins and rechannels deoxygenated blood flow through healthier veins that can safely return it to the heart.
How to Dress a Venous Ulcer Wound
Your healthcare provider will show you how to care for a venous ulcer wound. Keeping the wound clean and bandaged can speed up healing.Clean the wound thoroughly before applying a bandage and moisturize the skin around the wound. After you put the bandage on, wear a compression sock over it.
Before applying a wound dressing, any infected or necrotic (dead) tissue should be removed from the venous ulcer wound; eliminating this slough is calleddebridement.
Although it’s possible to debride and dress a venous ulcer wound at home, consulting with a healthcare provider and having professional help throughout this process is best.
Untreated Venous Ulcer: Risk and Complications
If left untreated, venous ulcers can become infected and increasingly painful. Treat venous ulcers promptly to avoid complications such as aninfectionorcellulitis.
Venous ulcers that remain unhealed after four to six weeks are considered chronic leg ulcers. In addition to infection risks and experiencing intense pain, chronic leg ulcers are associated with reduced mobility and decreased quality of life.
Causes vs. Risk Factors
Roughly 60% of venous ulcers become chronic (long-term) leg wounds.Even with best-practice treatment, up to 30% of venous leg ulcers fail to heal.If you notice signs of infection like redness, odor, fever, or chills, contact your healthcare provider immediately.
Summary
Venous ulcers are wounds or open sores that typically form on the inner lower leg above the ankle. The most common cause of venous leg ulcers is poor blood flow in the veins that return blood from lower limbs to the heart. Along with proper wound care, the key to healing and preventing venous ulcers heal is to do things that improve lower leg circulation like wearing compression stockings, exercising, and getting physical therapy.
In addition to these home remedies, a healthcare provider may refer you to a vascular surgeon or prescribe medicine that improves lower leg blood flow and helps venous leg ulcers heal faster.
16 Sources
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Probst S, Weller CD, Bobbink P, et al.Prevalence and incidence of venous leg ulcers—a protocol for a systematic review.Syst Rev. 2021;10(1):148. doi:10.1186/s13643-021-01697-3
Santler B, Goerge T.Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment.JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2017;15(5):538-556. doi:10.1111/ddg.13242
Johns Hopkins Medicine.Venous ulcers.
MedlinePlus.Venous ulcers - self-care.
Bull RH, Clements D, Collarte AJ, Harding KG.The impact of a new intervention for venous leg ulcers: A within‐patient controlled trial.International Wound Journal. Published online February 13, 2023:iwj.14107. doi:10.1111/iwj.14107
Ghosh SK, Al Mamun A, Majumder A.Clinical presentation of varicose veins.Indian J Surg. 2023;85(S1):7-14. doi:10.1007/s12262-021-02946-4
Alavi A, Sibbald RG, Phillips TJ, et al.What’s new: Management of venous leg ulcers.Journal of the American Academy of Dermatology. 2016;74(4):643-664. doi:10.1016/j.jaad.2015.03.059
Williams KJ, Ayekoloye O, Moore HM, Davies AH.The calf muscle pump revisited.Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2014;2(3):329-334. doi:10.1016/j.jvsv.2013.10.053
Yim E, Kirsner RS, Gailey RS, Mandel DW, Chen SC, Tomic-Canic M.Effect of physical therapy on wound healing and quality of life in patients with venous leg ulcers: A systematic review.JAMA Dermatol. 2015;151(3):320. doi:10.1001/jamadermatol.2014.3459
Sun SY, Li Y, Gao YY, Ran XW.Efficacy and safety of pentoxifylline for venous leg ulcers: an updated meta-analysis.The International Journal of Lower Extremity Wounds. Published online November 15, 2021:153473462110507. doi:10.1177/15347346211050769
Veith AP, Henderson K, Spencer A, Sligar AD, Baker AB.Therapeutic strategies for enhancing angiogenesis in wound healing.Advanced Drug Delivery Reviews. 2019;146:97-125. doi:10.1016/j.addr.2018.09.010
Gethin G, Cowman S, Kolbach DN.Debridement for venous leg ulcers. Cochrane Wounds Group, ed.Cochrane Database of Systematic Reviews. 2015;2019(9). doi:10.1002/14651858.CD008599.pub2
Quirke M, Ayoub F, McCabe A, et al.Risk factors for nonpurulent leg cellulitis: a systematic review and meta-analysis.Br J Dermatol. 2017;177(2):382-394. doi:10.1111/bjd.15186
Parker CN, Finlayson KJ, Shuter P, Edwards HE.Risk factors for delayed healing in venous leg ulcers: A review of the literature.Int J Clin Pract. 2015;69(9):967-977. doi:10.1111/ijcp.12635
Frykberg RG, Banks J.Challenges in the treatment of chronic wounds.Advances in Wound Care. 2015;4(9):560-582. doi:10.1089/wound.2015.0635
Bouguettaya A, Gethin G, Probst S, Sixsmith J, Team V, Weller C.How health literacy relates to venous leg ulcer healing: A scoping review. Beeckman D, ed.PLoS ONE. 2023;18(1):e0279368. doi:10.1371/journal.pone.0279368Porter M.A case study of venous leg ulceration.Br J Community Nurs. 2018;23(Sup9):S30-S36. doi:10.12968/bjcn.2018.23.Sup9.S30Shenoy Mm.Prevention of venous leg ulcer recurrence.Indian Dermatol Online J. 2014;5(3):386. doi:10.4103/2229-5178.137824
Bouguettaya A, Gethin G, Probst S, Sixsmith J, Team V, Weller C.How health literacy relates to venous leg ulcer healing: A scoping review. Beeckman D, ed.PLoS ONE. 2023;18(1):e0279368. doi:10.1371/journal.pone.0279368
Porter M.A case study of venous leg ulceration.Br J Community Nurs. 2018;23(Sup9):S30-S36. doi:10.12968/bjcn.2018.23.Sup9.S30
Shenoy Mm.Prevention of venous leg ulcer recurrence.Indian Dermatol Online J. 2014;5(3):386. doi:10.4103/2229-5178.137824
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