Venous stasis ulcers (VSUs), also referred to as venous ulcers, are long-term chronic sores that affect the lower extremities. It is estimated that nearly 1% of the US population experiences these ulcerations, and it is more common among the elderly population. This is due to the high frequency of related diseases such as calf muscle pump complications, diabetes, obesity, and edema. You can see Center for Vascular Medicine for vascular doctors and more on complications that may increase the chances of developing venous stasis ulcers. Another significant factor that may influence the development of venous stasis is a history of chronic venous insufficiency.
Signs and Symptoms of Venous Stasis Ulcers
A variety of symptoms could present in different patients depending on the severity of the VSU. In the initial stages, patients report sensations of a dull ache or pain in the lower extremities, varicose veins, swelling that heals soon after elevation, and a purple pigmentation around the surrounding skin. The ulcer starts taking a large, shallow, and irregular shape upon progression. The ulcer is mostly painful and typically develops right above the ankle.
If your physician suspects that you have a Venous stasis ulcer, they’ll book you for a complete physical. You will provide information about the onset and how you felt, including your observations used in diagnosis along with the findings from the physical exam. Other additional diagnostic tests that can be done include;
- Ankle-Brachial Index (ABI): This is a test to determine if there’s been decreased blood flow to the lower regions of the body. A doppler device is used to listen to blood flow and measure its pressure by placing pressure cuffs on both the arms and legs for comparison.
- Doppler Ultrasonography: This test is used to determine if there are blockages by using a doppler ultrasound device. The device measures how fast blood flows between several regions within the lower body.
- Imaging Tests: In addition, various imaging tests such as MRI scans, X-rays, and bone scans can help determine the extent of bone infection to know whether or not surgery is needed.
Although you can’t prevent or control certain risk factors associated with venous stasis, you can develop healthy lifestyle changes that can boost and maintain blood flow in your veins. Some of these healthy habits include;
- Quitting smoking. Any kind of smoking is injurious to your blood vessels. If you smoke, consider researching programs that can help you stop.
- Manage your diabetes. If you have diabetes, have a managing strategy to help keep your blood sugar always under control.
- Exercise. Develop and maintain an exercise program to always stay active to boost your blood flow.
- Keep your weight in check. The best way to do this is by watching what you eat along with exercising often. Adopt a diet with low sugar and low fat but plenty of fruits and vegetables to effectively manage your weight. Ensure also to get regular and enough sleep every night.
- Move around often. If your job involves sitting for long hours, you should create a routine that incorporates small breaks where you can walk around and stretch.
Although prevention methods are the most effective for preventing VSUs, patients still end up developing them for various reasons. Treatment and effective monitoring are essential for patients with VSUs. Left on its own untreated, this condition can lead to severe complications that could result in amputations or increased risk of death. Typically, most treatments will require an average period of between 6-12 months of therapy to promote healing. However, even with the long treatment periods, nearly three out of four patients develop a recurrence within 5 years.
Vascular physicians recommend individualizing the treatment to fit a particular patient depending on their overall health condition, current medications, physical and psychological ability, and willingness to perform self-care steps. Common treatments include the following;
- Compression Therapy: This has been the standard treatment for VSUs for a long time now. The process involves dressing the wound under compression bandages to increase the healing rate. These compression bandages are designed to increase blood flow upwards by gently squeezing your leg.
- Wound Debridement: Involves the careful removal of infected tissue from the VSU through a surgical process to boost wound healing.
- Antibiotics: Since VSUs take long periods to heal, they are prone to get infected with bacteria and becoming colonies. Various antibiotic treatment types are recommended depending on the condition of the VSUs. The more pronounced the infection, the stronger the doses advised.
- Adjunctive Therapy: Several adjunctive therapies may be used alongside the antibiotics. They include pulsed electromagnetic fields (PEMFs), pulsed ultrasound, and electrical stimulation.
- Surgery: In some cases, especially severe ones, surgery might be the only viable option. Surgical treatments are available in many categories depending on the kind of procedure. Common ones include skin grafting, stripping, sclerotherapy, and laser therapy.