Venous Leg Ulcers
Chronic wounds caused by unhealthy vein circulation require more than surface-level wound care. Treating the underlying venous disease can be an important part of healing and preventing recurrence.
Venous leg ulcers most commonly develop near the ankle and are often associated with chronic venous insufficiency, swelling, skin discoloration and inflammation.
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Why Venous Leg Ulcers Develop
When valves inside the leg veins do not function properly, blood can reflux or pool in the lower legs. The resulting pressure, swelling and chronic inflammation can damage surrounding tissue and eventually contribute to ulcer formation.
Venous Reflux
Damaged or malfunctioning valves allow blood to flow backward and accumulate in the lower leg.
Chronic Swelling
Elevated venous pressure can cause fluid to leak into surrounding tissues, producing persistent swelling.
Tissue Damage
Ongoing inflammation and impaired movement of oxygen and nutrients can weaken skin and contribute to wound formation.
Changes In The Skin Can Appear Before An Ulcer
Venous ulcers often occur after other signs of chronic venous disease have already developed. Visible varicose or spider veins may be an early indication of abnormal venous circulation.
Venous Disease May Involve More Than One Vein System
The source of a venous ulcer may involve superficial veins, perforator veins, deeper venous disease or a combination. Duplex ultrasound helps identify diseased vein segments and persistent reflux so treatment can address the circulation problem contributing to the wound.
Saphenous Vein Reflux
Abnormal flow within the major superficial veins can create sustained pressure in the lower leg.
Perforator Vein Reflux
Incompetent perforator veins can transmit high pressure toward the skin and areas affected by ulceration.
Non-Saphenous Reflux
Other refluxing branch veins may also contribute and may require targeted treatment based on ultrasound findings.
Healing The Wound And Managing Venous Insufficiency
Effective care may combine wound management with treatment of the abnormal venous circulation underneath it. The exact plan depends on the wound, vascular testing and the location of venous reflux.
Standard Wound Care
Cleaning, appropriate dressings and ongoing clinical monitoring help create an environment that supports healing.
Compression Therapy
When medically appropriate, compression bandages or stockings can help reduce swelling and improve venous blood flow.
Advanced Wound Care
Selected wounds may benefit from options such as bioengineered skin substitutes, negative pressure therapy or skin grafting.
Vein Treatment
Laser ablation, radiofrequency ablation or other targeted procedures may be used to address incompetent veins contributing to venous hypertension.
Good Wound Care Is Only Part Of The Picture
A venous ulcer may close with wound care, but persistent venous reflux can increase the likelihood of recurrence. Treating the underlying circulation problem can be an important part of long-term management.
If healing stalls, additional duplex ultrasound may be used to look for persistent reflux in perforator veins or branch varicose veins and guide additional treatment.
Explore Vascular TestingVenous Leg Ulcer FAQs
What is a venous leg ulcer?
A venous leg ulcer is a chronic open wound that develops when unhealthy venous circulation creates sustained pressure and inflammation in the lower leg. These ulcers commonly occur near the ankle.
What causes venous leg ulcers?
They are commonly associated with chronic venous insufficiency and venous reflux. Malfunctioning vein valves allow blood to pool in the legs, increasing pressure and contributing to swelling, inflammation and tissue damage.
How are venous leg ulcers diagnosed?
A clinical wound evaluation is often combined with duplex ultrasound to assess blood flow and identify superficial, perforator or other veins that may be refluxing.
How are venous leg ulcers treated?
Treatment may include wound care, medically appropriate compression therapy, advanced wound treatments and procedures that address underlying chronic venous insufficiency.
Why is treating the underlying vein problem important?
If abnormal venous reflux remains untreated, elevated pressure can continue to interfere with healing and may increase the risk that an ulcer returns after it closes.
How long does a venous leg ulcer take to heal?
Healing time varies according to the wound, circulation, overall health and treatment plan. The Vein & Wound Institute notes that many appropriately treated venous ulcers heal within several months, while some require longer-term care.