Venous Ulcers – Diagnosis and Treatment
Venous ulcers (also called Statis Ulcers) is a shallow wound that occurs in the lower part of the leg, typically between the calf and the ankle and on to the sides of the leg(s). Venous leg ulcers heal slowly and pose a risk of recurrence if not treated properly.
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Poor blood circulation in the legs leads to venous ulcers. Veins carry blood from all parts of the body to the heart. This is a one-way flow of blood and is regulated with valves in veins which restrict the blood flow in other directions. When the valves in the veins (near the legs) are damaged, the blood that is supposed to flow gets blocked in that area. The blocked blood flows into the surrounding tissues and results in breaking down of the tissue resulting in ulcers. As the blood flows into the surrounding areas, the skin in the area turns dark red or purple. The skin may become thick, dry, and itchy as the ulcer develops. In extreme cases, the ulcers may start leaking puss-like fluids.
Risk factors for developing venous leg ulcers
- Over weight – Being overweight puts tremendous pressure on several parts of the body such as the pelvis and legs. This also puts a heavy load on the blood circulation system.
- Age – With age, every part of the body becomes less efficient in performing its functions. As the skin of aged people is more fragile, the chances of forming an ulcer are higher.
- Smoking, lack of physical activities, deep venous thrombosis, and previous leg injuries can also cause venous ulcers on the legs.
- People suffering from varicose veins, high blood pressure, blood clotting disorders are at higher risk of developing venous leg ulcers.
Symptoms of Venous Ulcers
Many times, the ulcers cause no discomfort. But when the ulcers are infected, they can become painful. Symptoms of venous ulcers include:
- Inflammation of the area of the ulcer
- Swelling and Aching
- Itchy and Hard skin
- Scabbing or flaking
- Discharge from ulcer.
Diagnosis of Venous Ulcers
Your vascular surgeon usually starts with physical examination of the affected area. He/she will check for symptoms such as swelling of ankles, darkened skin or anything that is leaking out from the affected area. Then your doctor will try to find the root cause of the ulcer. (If the root cause is not found but the ulcer is treated, it is bound to recur after sometime). You need to let your doctor know if you have diabetes, DVT (deep vein thrombosis), Injury to your leg or any previous ulcer. Your doctor will be easily able to make out, if varicose veins are the cause of the ulcer. Your doctor may check the pulse in the ankle region to check for flow of blood through the arteries.
Then, you may be advised to get a Doppler study done which will check the flow of blood through the arteries by comparing the pressure. It is important to do a Doppler study because the treatment of venous ulcers involves using compression bandages or stockings to improve the blood circulation through veins in the legs. If your doctor sees that the blood pressure at the ankle is lower, bandages and stockings may not be advised.
Treatment of venous ulcers
The bottom line of venous ulcer treatment is to improve the blood flow to the affected area. Antibiotics may be prescribed if your doctor sees that there may be infection that might be the cause of the problem or antibiotics may be given as a pre-emptive measure.
If your doctor puts you onto bandage or stockings, he/she will train you on how to properly wear them and also dress your ulcer. Painkillers may be given to reduce the pain caused at the site.
If the cause of venous ulcers is varicose veins, your doctor may recommend appropriate treatment for varicose veins. Laser treatment for varicose veins is one popular treatment option employed many vascular surgeons in Chennai and across the world.
Can you ignore venous ulcers?
Ignoring venous ulcers and leaving them untreated can result in serious complications. It is good if you can see your doctor when you experience pain or inflammation of between calf and the ankles on the sides of the legs.
If is important to treat the root cause than getting some over the counter medicines that can help in relieving the symptoms.