Venous ulcers or venous stasis ulcers are ulcers that usually appear on the inner part of the leg, near the ankle. When the valves in veins of legs do not function properly, the blood that is supposed to flow upwards towards heart may flow back a little (retrograde) and get pooled (stasis). If this continues, it can lead to increased pressure in the veins. As the venous hypertension gets worse, fluid may leak from the veins and get pooled in tissue (edema). This mainly occurs near ankle area. Chronic venous insufficiency makes this worse where protein may accumulate in the tissue as well. At some point the circulation becomes so restricted that proper nutrient exchange does not take place. In addition to the lack of Oxygen and nutrients in the tissue, the fibrin (which normally plays a role in clotting) from the fluids adds to the insult and leads to necrosis and ulceration.
The venous ulcers start small but may grow in size. They are shallow with irregular edges and may have clear, yellow or red drainage. If they are not properly cared for, they have potential to get infected.
Diagnosis is usually based on good history and physical examination. Lower-extremity duplex ultrasound can be used to measure ankle-brachial index.
Although not usually fatal, these chronic wounds severely affect patients’ quality of life because of impaired mobility and substantial loss of productivity. The treatment focuses on improving blood flow to the affected area. The wound needs to be dressed regularly. Unna boot application is a great dressing with Zinc and Calamine. But the main treatment focuses on treating the underlying problem. Hence proper diagnosis by a vein expert is the key to treating and preventing venous ulcers.