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Venous ulcers - self-care

Venous leg ulcers - self-care; Venous insufficiency ulcers - self-care; Stasis leg ulcers - self-care; Varicose veins - venous ulcers - self-care; Stasis dermatitis - venous ulcer

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Description

Venous ulcers (open sores) can occur when the veins in your legs do not push blood back up to your heart as well as they should. Blood backs up in the veins, building up pressure. If not treated, increased pressure and excess fluid in the affected area can cause an open sore to form.

Most venous ulcers occur on the leg, above the ankle. This type of wound can be slow to heal.

Causes

The cause of venous ulcers is high pressure in the veins of the lower leg. The veins have one-way valves that keep blood flowing up toward your heart. When these valves become weak or the veins become scarred and blocked, blood can flow backward and pool in your legs. This is called venous insufficiency. This leads to the high pressure in the lower leg veins. The increase in pressure and buildup of fluid prevents nutrients and oxygen from getting to tissues. The lack of nutrients causes cells to die, damaging the tissue, and a wound can form.

Signs and Symptoms

When blood pools in the veins of the lower leg, fluid and blood cells leak out into the skin and other tissues. This can cause itchy, thin skin and lead to skin changes called stasis dermatitis. This is an early sign of venous insufficiency.

Other early signs include:

Signs and symptoms of venous ulcers include:

Who is At Risk?

Risk factors for venous ulcers include:

Wound Care

Your health care provider will show you how to care for your wound. The basic instructions are:

To help treat a venous ulcer, the high pressure in the leg veins needs to be relieved.

If ulcers DO NOT heal well, your provider may recommend certain procedures or surgery to improve blood flow through your veins.

Prevention

If you are at risk for venous ulcers, take the steps listed above under Wound Care. Also, check your feet and legs every day: the tops and bottoms, ankles, and heels. Look for cracks and changes in skin color.

Lifestyle changes can help prevent venous ulcers. The following measures may help improve blood flow and aid healing.

When to Call the Doctor

Call your provider if there are any signs of infection, such as:

References

Hafner A, Sprecher E. Ulcers. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 105.

Leong M, Murphy KD, Phillips LG. Wound healing. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 6.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Wound care and dressings. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 25.

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Review Date: 4/5/2018  

Reviewed By: Michael Sobel, MD, Professor of Vascular Surgery, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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