Venous Ulcer

Venous ulcers (open sores) can occur when the veins in your legs don’t push blood back up to your heart as well as they should.

Blood backs up in the veins, building up pressure. If not treated, increased pressure and excess fluid can cause an open sore to form.

Most venous ulcers occur on the leg, above the ankle. This type of wound can be slow to heal.

 

 

If you are at risk for venous ulcers, take these steps to help prevent problems.

  • Raise your feet above your heart as often as possible.
  • Wear compression socks every day.
  • Avoid sitting or standing for long periods of time.
  • Check your feet and legs every day: the tops and bottoms, ankles, and heels. Look for cracks and changes in skin color.

Certain lifestyle changes can help prevent venous ulcers.

If you have a wound, take these steps to help improve blood flow and aid healing.

  • Quit smoking. Smoking is bad for your blood vessels.
  • If you have diabetes, keep your blood sugar levels under tight control. This will help you heal faster.
  • Exercise as much as you can. Staying active helps with blood flow.
  • Eat a healthy diet and get plenty of sleep at night. Staying healthy will help wounds heal.
  • Lose weight if you are overweight.
  • Manage your blood pressure and cholesterol levels.

 

Risk factors for venous ulcers include:

  • Varicose veins
  • History of blood clots in the legs (deep vein thrombosis)
  • Leg swelling
  • Age
  • Being female (related to levels of the hormone progesterone)
  • Being tall
  • Family history of venous insufficiency
  • Obesity
  • Pregnancy
  • Smoking
  • Sitting or standing for a long periods 
  • Long bone fractures or other serious injuries, such as burns or muscle damage

 

The veins in your legs have one-way valves that keep blood flowing up toward your heart. When these valves become weak, blood can flow backward and pool in your legs. This is called venous insufficiency. The excess fluid causes the blood pressure to build up in your legs. The increase in pressure and buildup of fluid prevents nutrients and oxygen from getting to tissues. The lack of nutrients causes cells to die, damaging the tissue, and a wound can form.

When blood pools in the veins of the lower leg, fluid and blood cells leak out into the skin and other tissues. This can cause itchy, thin skin and lead to skin changes.

Early signs include:

  • Leg swelling, heaviness, and cramping
  • Dark red, purple, brown, hardened skin (this is a sign that blood is pooling)
  • Itching and tingling

Signs and symptoms of venous ulcers include:

  • Shallow sore with a red base, sometimes covered by yellow tissue
  • Unevenly shaped borders
  • Surrounding skin may be shiny, tight, warm or hot, and discolored
  • Leg pain
  • If the sore becomes infected, it may have a bad odor and pus may drain from the wound

 

To help treat a venous ulcer, you want to improve blood flow to your legs.

  • Wear compression stockings or bandages every day. They help prevent blood from pooling, reduce swelling, help with healing, and reduce pain.
  • Put your feet above your heart as often as possible. For example, you can lie down with your feet propped up on pillows.
  • Take a walk or exercise every day. Being active helps improve blood flow.
  • Take medications as directed to help with healing.

If ulcers do not heal well, your doctor may recommend certain procedures or surgery to improve blood flow through your veins.