A venous ulcer is a leg wound or injury, also named a varicose ulcer or a venous stasis ulcer. A vascular ulcer develops when the leg veins fail to return blood to the heart. Blood can collect in the veins, applying pressure to the skin and raising the risk of an open sore. The varicose ulcer’s vein commonly appears on the sides of the lower leg, above the ankle, and below the calf. They typically recur because they heal slowly. If left untreated, they could enlarge and worsen the condition of your legs.
Causes of varicose ulcer
Numerous variables, usually related to one’s lifestyle, might induce varicose ulcers. Venous leg ulcers can result from the following;
- Obesity
- Smoking
- Prolonged standing or sitting
- Hypertension in the veins
- Insufficient veins
- Dilated veins
- Poor circulation or blood clots
- Inflammatory disorders, diabetes, and renal disease
- Certain medications
- Infections
Symptoms of varicose ulcer
Symptoms of a varicose or venous ulcer include;
- Thick, dry, and itchy skin (in dark red or purple color)
- Enlarged and painful legs
- An irregularly shaped, shallow red sore with clear, yellow, or crimson discharge
- Cramps and swollen legs
- Dull pain or a sense of weight in the calf or leg
- Red and tingly skin with itching
- Hardened skin with dark red, purple, and brown patches (indicators of blood pooling)
- Glossy and tight skin around the ulcers that are warm to the touch or even heated
Risk factors of varicose ulcer
The following are risk factors that may contribute to varicose ulcers;
- Age: As you grow older, your veins and valves become less elastic and weaken, which might result in venous ulcers.
- Being female: Women are more likely to develop venous leg ulcers than men.
- Deep vein thrombosis: varicose ulcers can cause by blood clots formed in the leg’s deep veins.
- Family background: Varicose ulcers may run in families.
- Pregnancy: Pregnancy can occasionally create lower leg pressure that leads to valve venous or varicose ulcers.
- Varicose vein: Venous or varicose ulcers are more likely to develop in patients with varicose veins.
- Venous insufficiency: Blood accumulates in the legs when leg veins cannot circulate blood effectively and can cause venous insufficiency ulcers.
Complications
Following numerous severe health issues can result from venous or varicose ulcers;
- Loss of mobility: A venous leg ulcer may cause pain, preventing one from engaging in routine activities.
- Venous ulcers are susceptible to infection. Blood poisoning or a bone infection may result from an untreated venous ulcer.
Diagnosis of varicose ulcer
Your doctor will perform a complete physical exam, including checking your blood pressure in your arm and ankle if a varicose ulcer is suspected. A solid diagnosis is the cornerstone of effective leg ulcer treatment. Additional tests could consist of;
- Ankle-brachial index test: The ankle-brachial index test involves applying blood pressure cuffs to the arms and ankles. Handheld ultrasound equipment, or “Doppler,” is employed to hear the blood flow and gauge blood pressure. It aids medical professionals in determining whether there is reduced blood flow to the lower legs and feet.
- Ultrasound: A doctor can use an ultrasound machine to monitor your blood pressure at several spots on your arm or leg to check any blockages and how rapidly your arteries in the lower leg are circulating blood.
Leg ulcers caused by venation should be examined for infection. Additionally, the subsequent tests could be applied:
- Imaging tests: Imaging studies such as X-rays, MRIs, or bone scans can assist diagnose bone infections and evaluating whether surgery is required to obliterate the infected venous ulcer.
Preventions
You can take certain precautions to lower or lessen your risk of acquiring venous ulcers even though you cannot completely avoid some factors for the condition;
- Avoid smoking: Talk to your doctor about programs and techniques to stop or avoid smoking.
- Manage high blood pressure and cholesterol: A healthy diet, regular exercise, and medication can help you control high blood pressure and cholesterol level.
- Manage your diabetes: Keep a close eye on your blood sugar levels.
- Maintaining a healthy weight: It involves eating a low-fat, low-sugar diet, a diet rich in fruits and vegetables, and engaging in frequent exercise.
- Use of Compression Stocking: People with chronic venous insufficiency should wear compression stockings daily.
- Avoid spending prolonged periods sitting or standing: Regularly pause to stretch and walk.
Treatment of varicose ulcer
Treatment refers to treating the ulcer and lowering the elevated blood pressure in the leg veins. It includes;
- Pressure management in the leg vein: The swelling must be controlled to treat venous leg ulcer patients. Elevating the legs, so the foot is at or above the heart’s level throughout the day. Legs are frequently wrapped in bandages or compression wraps. Elastic compression stockings could be suggested if the leg ulcer has shrunk or is almost healed. The legs are fitted with compression stockings, usually put on in the morning and worn all day. Patients with significant edema could need a venous pump.
- Surgery: Advanced wound care and treatments are necessary for patients with varicose veins who have acquired sores that don’t heal well. The latest varicose vein treatments are safe, minimally invasive, and can be done at outpatient surgical centers or doctors’ offices. Depending on the vein groups that are generating the symptoms, there are many treatment options, such as:
- Endovenous ablation: An outpatient operation can be performed to treat the varicose ulcer. In either the great or small saphenous vein, a catheter is placed. Once the numbing medicine is injected into the skin around the vein’s location, the vein is heated with radio waves or a laser, which takes less than ten minutes. The deep vein system receives the blood before being redirected from the treated superficial vein.
- Ambulatory phlebectomy: This branch of varicose vein treatment can be done as an outpatient procedure or at a doctor’s office. The doctor indicates the veins that need to be removed. Numbing medicine is injected into the skin along the path of the veins to be treated. A tiny hook is used to extract the veins after making tiny skin nicks or incisions. Usually, stitches will not be made due to pretty small incisions. The leg is dressed, and patients are free to walk right away following the treatment.
- Sclerotherapy: This varicose vein treatment can be done as an outpatient procedure or at a doctor’s office. A tiny needle filled with a substance is used to inject smaller veins. There is no need for any anesthetic or numbing medication during this procedure. Smaller veins, often called spider veins can be effectively treated with this kind of therapy.
References:
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/venous-ulcers
- https://www.baptisthealth.com/services/heart-care/conditions/venous-ulcer
- https://medlineplus.gov/ency/patientinstructions/000744.htm
- https://www.upmc.com/services/heart-vascular/conditions-treatments/venous-ulcers
- https://www.webmd.com/skin-problems-and-treatments/venous-skin-ulcer
