What Is a Venous Wound?

A "venous wound" is also known as a venous stasis ulcer or a venous leg ulcer. Venous ulcers develop on the legs due to problems with the flow of blood through the leg veins. According to the Columbia University Department of Surgery, 1 out of 1,000 patients in the United States have an unhealed venous ulcer at any given time. The painful and frustrating condition primarily affects the elderly. Venous wounds do not heal easily, and some large ones never heal. Nevertheless, you can take actions to help the wound heal and reduce the chance of recurrence.

Causes

• Venous ulcers occur when there is insufficient blood flow through the leg veins (venous insufficiency), which creates hypertension in the veins. Lack of sufficient blood flow causes blood to pool in the veins, which forces fluid out of the blood vessels into the surrounding tissue. This prevents the normal movement of oxygen and nutrients to the tissues, which are also under pressure due to the leaked fluid. The ulcer forms in result of the tissue damage.

  Any condition that causes blood to pool in the veins, such as a varicose vein, can cause a venous ulcer. When the vein is damaged, chronic venous insufficiency develops.

Risk Factors

• The risk of developing venous ulcers increases not only with age but with a history of swollen legs, leg injury, vein disease, blood clots or tumors. The overweight and people with low activity levels are also at greater risk. Heredity increases risk as well.

Symptoms

• There may be one or more ulcers, where the skin has shed and exposed underlying tissues. You may find spots of white scar tissue around the ulcer.

  If chronic venous insufficiency caused the ulcer, the ulcer will usually be painful and there will be further symptoms. The legs may be swollen and skin of the legs may be itchy, brownish and very firm.

  The skin around the ulcers is usually infected as well, a condition called cellulitis. An infected ulcer may leak pus or fluid and the skin around it will be warm, tender, red and swollen.

Management

• Infected ulcers are treated with antibiotics. For the ulcer to heal, the patient will have to wear compression (either bandages or medical stockings) at all times.

  Elevation of the legs above heart level, exercise, avoidance of standing and sitting in one place for long periods, washing the legs and applying lanolin-and-perfume-free moisturizer, and use of compression stockings will all help the wound to heal. The right type and level of exercise should be determined in consultation with your doctor. In addition, good, protein-rich nutrition is important, because the fluid leaking from the wound is protein.

  Skin grafting is a surgical option for faster healing, especially if the wounds are large or will not otherwise heal. Other surgery is possible depending on your condition.

Prevention

• The best way to prevent the eventual development of venous ulcers that is within a person's control is a high level of activity using your legs, regardless of age. If your job involves a lot of sitting or standing in place, make sure that you make time in your life for walking, swimming or cycling.