What Are Venous Ulcers?

Chronic vein disease develops several stages, of which venous ulcers are generally the last and the most serious. These open, shallow wounds on the lower leg or ankle are slow to heal and can quickly become infected if not treated. About 1% of Americans develop these ulcers. They are common in older people, especially women.

Interventional radiologist Dr. Dev Batra and his team at Dallas Vein Institute have extensive knowledge about chronic vein disease and venous ulcers. The team uses state-of-the-art diagnostic tools to understand the underlying cause of your problem, as well as advanced treatment options for getting you back to better vein health. Here’s what we want you to know about venous ulcers.

The stages of chronic vein disease

If not treated, vein disease can become a progressive problem with multiple stages, including:

1. Chronic venous insufficiency (CVI)

CVI occurs when one-way valves in your legs become damaged, allowing blood destined for the heart to flow backward and pool around the valve, inhibiting normal circulation.

2. Spider veins

These widened venules or reticular veins (small rope-like veins) form in thin, web-like patterns on the skin as venous blood pressure rises and stresses the vein’s wall.

3. Varicose veins

If CVI is left untreated, spider veins give way to varicose veins as the larger veins become affected. They appear on the legs as ropy, twisted, and colored swellings. They may cause symptoms, including pain, swelling, itchiness, and an aching heaviness.

4. Edema

The veins begin to leak, causing swelling in the surrounding area. If you press on the skin, it may leave an indentation.

5. Venous stasis dermatitis

You notice significant changes in the appearance of the skin over the affected veins. Most common is a brown or red discoloration around your ankles and lower legs caused by hemosiderin deposits, a breakdown product of your blood’s hemoglobin. You can also experience scaly, shiny, or thickened skin, along with skin scarring. Untreated, the condition will eventually lead to venous ulcers.

6. Venous ulcers

Venous ulcers are usually easy to identify. Located on the lower leg or ankle area, the open sores may be encircled by discolored skin or hardened skin with irregular borders. The base of the ulcer is usually red. It can produce a large amount of exudate depending on the infection and, when touched, will ooze venous blood. The wound itself is relatively painless, but people can experience a great deal of pain from subsequent infection or edema.

Venous ulcers are slow to heal. They quickly become infected if not treated appropriately, especially for diabetics.

Diagnosing venous ulcers

Venous ulcers are easily diagnosed based on sight alone. To confirm, Dr. Batra uses state-of-the-art diagnostic tools, including vascular ultrasound and ankle-brachial index testing, to determine the underlying cause. In most cases, the problem is traceable to chronic vein disease.

Treating venous ulcers

When treating venous ulcers, the primary goals are keeping the ulcer infection-free while healing and alleviating the edema at the site. Our team may use debridement — removal of dead tissue and surface contamination — so it can heal normally.

Typically, you’ll only need oral antibiotics if the surrounding tissue is infected. Keep the wound environment moist, with dressings changed as infrequently as possible, since changing dressings removes healthy cells. In extreme cases, surgical skin grafts may help abnormally large or painful venous ulcers.

Most ulcers heal after 3-4 months of treatment, though some can take longer, and some may never resolve.

At Dallas Vein Institute, Dr. Batra treats ulcers by treating the underlying vein disease — the most effective way to get rid of the veins causing your problems. Techniques include:

Treatment generally focuses on both the primary diseased vein as well as the tributary veins feeding it. 

If you’re noticing the symptoms of any stage of vein disease, it’s time to make an appointment with Dallas Vein Institute to get the treatment you need. You can call the office at 972-646-8346 to schedule your consultation or book online today.

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