Venous Leg Ulcer
What are Venous Stasis Ulcers?
Venous stasis ulcers, also known as venous leg ulcers, are wounds on the lower legs that heal poorly due to poor blood circulation. They typically affect the area near the medial malleolus (inside the ankle bone). They often occur in elderly individuals with underlying health conditions like diabetes or heart issues and are more common in women than men.
The leading cause of venous ulcers is chronic venous insufficiency (CVI), a condition in which blood flow in the veins is impaired. This is often due to weakened vein walls and valves that develop over several years.
How a Venous Leg Ulcer Develops?
Due to chronically dysfunctional veins (known medically as chronic venous insufficiency), the veins are no longer able to transport blood from the legs back to the heart quickly. The valves that generally prevent the backflow of blood within the veins become less efficient, causing blood to pool and the veins to widen. This stasis eventually damages the smallest blood vessels, or capillaries, which are responsible for supplying cells with oxygen and nutrients and removing metabolic waste from tissues. When these capillaries can no longer function effectively, blood backflow increases pressure at the lower limb.
As a result, the skin in the affected areas becomes sensitive, loses its elasticity, and hardens. This weakened skin makes it difficult for even minor cuts or scrapes to heal. Over time, the skin may start to break down, and even the most minor injury can develop into an open, weeping wound.
These open wounds are often excruciating and may feel itchy or have a burning sensation. Rashes can appear, and the skin becomes dry and discolored, often with a brownish hue. Microorganisms that colonize the wound and surrounding area can cause unpleasant odors. This can lead to social withdrawal, as affected individuals may feel self-conscious and avoid contact with others.
Pain from the ulcer often leads patients to adopt protective postures, moving the affected leg as little as possible. This lack of mobility reduces the natural pump mechanism that assists in blood flow back to the heart, creating a vicious cycle where reduced blood flow and inactivity exacerbate the condition.
Healing Prognosis
While some individuals may struggle with venous leg ulcers for years, the outlook for healing is generally favorable. With the treatment options available today, approximately 90% of all venous leg ulcers can be successfully healed.