Vein Problems


Varicose Veins with Ulcer
Varicose Veins with Ulcer

Venous ulcers (also known as varicose ulcers or stasis ulcers) usually occur in the lower part of the leg, most commonly around the ankle area, in patients who have long standing venous reflux.

Venous reflux is due to faulty venous valves which allow the blood in the veins to flow in the wrong direction, thereby causing pooling of blood in the affected veins. Over time these veins stretch and become dilated and tortuous. At this stage, the dilated veins maybe obvious to the patient as varicose veins.

If left untreated, venous reflux leads to a condition called venous hypertension in the affected leg. Not only is the flow of blood in these veins impaired, venous hypertension causes leakage of proteins and other blood products into the soft tissue of the leg, resulting in swelling of the leg, with thickening and increased pigmentation of the skin. This state is also called chronic venous insufficiency. Ultimately, the skin at the most dependent part of the leg, usually around the ankle area, breaks down to form a chronic wound, the venous ulcer.

Venous ulcers can be very painful and they can get infected. They are very difficult to treat and have a tendency to recur. Untreated venous ulcers lead to a miserable quality of life for the patient.

The best defense against venous ulcers is prevention. This means not allowing the venous reflux to progress without treatment to such a late stage. Early detection and appropriate treatment of varicose veins and other venous disorders is important to reduce the risk of developing this debilitating, difficult to treat problem.

The initial treatment is usually with compression therapy. This is done with multi-layer bandaging of the affected leg. The bandages are changed weekly in the clinic. It takes about 8 weeks on average for a typical venous ulcer to heal with this regime. After the ulcer heals, the patient needs to use venous compression stockings. Certain medications can help in healing the ulcer and to reduce the risk of recurrence.

In most patients with venous ulcers, treating varicose veins properly even at this late stage will help the ulcers to heal and reduce the chance of them recurring.