Venous Stasis Ulcers: Causes, Symptoms, and Treatment

Venous stasis ulcers, a condition often called venous leg ulcers, are a painful, relatively common medical issue affecting countless individuals worldwide. According to Wounds International, one percent of the global population, among those aged 18–64, have lower extremity ulcers—70 percent of which are caused by chronic venous insufficiency (CVI). In the United States, 4 percent of the population has active leg ulcers. The prevalence increases with age.

The term "leg ulcer" is generally used to describe a full-thickness open wound below the knee that tends to heal slowly. According to the National Library of Medicine (NIH), leg ulcers more frequently impact females, those who are obese, immobile, or have a history of deep vein thrombosis (DVT) or phlebitis. Leg ulcers reduce mobility, increase poor quality of life, and are a significant financial burden on patients and health care systems.

This blog will delve into the complexities of venous stasis ulcers, examining their causes, symptoms, and treatment options.

What is a venous stasis ulcer?

Venous stasis leg ulcers are essentially open sores or wounds that develop on the lower legs, particularly around the ankles, that are closely associated with chronic venous insufficiency (CVI). CVI is a condition where the veins in the legs struggle to effectively return blood to the heart. The resulting blood pooling in the lower leg can lead to various symptoms and, in severe cases, open sores on the legs.

Leg ulcers are often chronic, meaning they persist for an extended period and can significantly impact a person's quality of life. Understanding the underlying causes and contributing factors to venous stasis ulcers is essential for both prevention and effective treatment.

Chronic venous insufficiency and the venous stasis ulcer

Chronic venous insufficiency plays a central role in developing venous stasis ulcers. CVI is a condition where the veins in the legs struggle to transport blood back to the heart. Normally, one-way valves in the veins help maintain blood flow towards the heart. However, these valves become damaged or weakened with CVI, resulting in blood pooling in the lower extremities.

The increased pressure within the veins causes inflammation and damage to the skin and surrounding tissues, eventually forming ulcers. While CVI is the primary factor, other contributing elements may include obesity, aging, family history, and lifestyle factors such as prolonged standing or sitting.

Symptoms of venous stasis ulcers

Venous stasis ulcers present with a range of noticeable symptoms, making them relatively easy to identify. The most common signs and symptoms include:

Pain and discomfort: Patients often report aching, throbbing, or burning sensations in the affected area. This pain may worsen when standing or walking and improve when elevating the legs.

Swelling (edema): The fluid accumulation in the affected leg can lead to significant swelling, contributing to discomfort.

Discolored skin: The skin around the ulcer may appear discolored, typically taking on a reddish-brown or purplish hue. Skin changes may also include a thickening or hardening of the affected area.

Itching and irritation: Patients may experience itching and irritation around the ulcer site.

Open sores: The most characteristic sign is, of course, the presence of open, often painful ulcers. These ulcers are slow to heal and can be prone to infection if not managed properly.

It's worth noting that venous stasis ulcers can be more than a physical burden. The chronic nature of the condition, along with pain and discomfort, may lead to reduced mobility and a diminished quality of life for affected individuals.

"As well as being challenging clinically and economically, venous leg ulcers cause patients a wide range of psychosocial issues, including depression, anxiety, and social isolation." – "The impact of venous leg ulcers on a patient's quality of life: considerations for dressing selection," Wounds International, February 7, 2023

Treatment for venous stasis ulcers

Treating venous stasis ulcers often involves a multifaceted approach, aiming not only to heal existing ulcers but also to manage the underlying chronic venous insufficiency to prevent recurrences. Here are some common treatment options:

Compression therapy: Using compression stockings or bandages helps improve blood flow in the legs, reducing swelling and promoting the healing of ulcers.

Wound care: Proper wound care is crucial. Cleaning and dressing the ulcers can help prevent infection and support healing.

Leg elevation: Elevating the legs above the heart level helps reduce swelling and improve blood flow. Stanford Medicine Health Care recommends elevating your feet above the level of your heart three or four times a day for about 15 minutes at a time, especially if you sit or stand for long periods of time.

Medications: In some cases, medications may be prescribed to manage pain, reduce inflammation, or control infection.

Minimally invasive procedures: Center for Vein Restoration offers several in-office treatments that take an hour or less to complete and allow patients to return to their regular routine immediately.

Treatment options include:

• Laser Ablation uses laser energy to seal off damaged veins, allowing for better blood flow.
• Radiofrequency ablation uses radio waves, which heat specific areas of the affected vein, causing it to close.
• Sclerotherapy uses a medicine called a sclerosant injected into the problem vein to close it.
• Ambulatory phlebectomy is a minor surgical procedure during which the diseased vein is removed through tiny incisions. No stitches required

Surgical Options: In severe cases, surgical procedures may be considered to remove non-healing tissue. Options include debridement and skin grafting.

Preventing Venous Stasis Ulcers

Like any other medical condition, prevention is always preferable to treatment. Here are some steps individuals can take to reduce the risk of developing venous stasis ulcers:

Maintain a healthy lifestyle: Exercise regularly and maintain a healthy weight to promote good circulation.

Manage chronic conditions: Control chronic conditions like diabetes and hypertension, which can worsen venous insufficiency, which can lead to leg ulcers.

Avoid prolonged sitting or standing: If your job or daily routine requires long periods of sitting or standing, take regular breaks to move and stretch.

Wear compression stockings: If you have a history of venous insufficiency, your healthcare provider may recommend compression stockings for prevention.

Regular check-ups: Regularly see your healthcare provider for venous insufficiency evaluation and early intervention if necessary.

Have a leg ulcer? Center for Vein Restoration can help

While leg ulcers can be caused by diabetes, peripheral artery disease (PAD), or high blood pressure, between 60 and 80 percent of all leg ulcerations that occur in the presence of venous disease, according to the NIH, since Center for Vein Restoration (CVR) is the leader in the diagnosis and treatment of venous disease, those suffering from venous stasis ulcers can get expert leg ulcer care at any of the 110+ CVR vein care clinics across the United States.

CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.

Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR vein clinic near you today.