Venous ulcers are the most common type of ulcers occurring in the lower limbs, accounting for more than half of all ulcer cases. A venous ulcer typically appears as a wound or skin ulcer, resulting from a breakdown of the surrounding cells and tissue layers.
Venous leg ulcers occur when the one-way valves of the veins fail to maintain the blood flow toward the heart and prevent any back flow. This problem with blood flow is known as venous insufficiency. The venous system in the lower limbs includes the deep, superficial and profound veins; where the deep veins lie between the muscles, the superficial veins in the upper layers just below the skin, and the profound veins are located in between, connecting the other two types of veins. In damaged valves, the blood backs up and pools in the veins, building up pressure, which prevents nutrients and oxygen in the blood from reaching the body tissue. Eventually, the tissue breaks down and forms an ulcer.
Lower limbs are the most common sites of venous ulcers, especially the inner areas of the ankle and legs. A sign of potential trouble can be detected when the skin starts turning a brown-purple color (indicating blood pooling in veins) and the legs swell. While the ulcer itself is usually painless, the surrounding tissue might get dry, itchy and thickened, or it might get infected; in which case, it will emit a foul odor and pus may drain out of it.
Venous ulcers are much more likely to occur in:
Treating a venous ulcer is based on the status of circulation. Better circulation leads to easier treatment, better healing and fewer complications. Treatment can include raising the legs above the heart level as often as possible and wearing compression socks. These measures can improve circulation and prevent blood from pooling in the veins. Regular walking and exercising are also recommended to help improve circulation and encourage healing. Another important medical intervention is to treat the underlying cause of a venous ulcer, which may include improving the management and control of any chronic illnesses that are present.
Sometimes extensive wound cleansing is needed. Antibiotics can be given orally or applied directly on the ulcer, along with a wet dressing or drying agents, as appropriate. In some cases, a graft (skin taken from other parts of body) is used to cover the ulcer to heal it.
To help prevent venous leg ulcers, these measures may be followed: