Venous Ulcer

What is a venous ulcer?

A venous ulcer, also called a stasis ulcer, is a shallow wound that usually develops on the legs as a result of advanced vein disease. Venous ulcers are common in patients who have a history of leg swelling, varicose veins, venous insufficiency, certain health conditions or blood clots in either the superficial or deep veins of the legs. Venous ulcers affect over 500,000 people in the United States every year and account for approximately 80 percent of all leg ulcers.

What Causes a Venous Ulcer?

Vein disease is the root cause of a venous ulcer. Vein disease develops when the one-way valves inside of a vein stop functioning correctly. The one-way valves are designed to push blood toward the heart; however, sometimes the valves weaken and are unable to adequately return the blood to the heart. As a result, excess blood remains in the vein, which creates increased pressure on the vein wall. Further, the excess blood has nowhere to go, so it pools in the lower extremities. The pooled blood may seep out of the vein and into surrounding tissue, causing the skin to become discolored and tender. If left untreated, the excess blood and pressure can break down the skin from the inside out and create open, painful sores on the surface of the skin. Once a venous ulcer has developed, it can be challenging to treat and can take weeks, months or even years to heal.

What are the symptoms?

Before a venous ulcer develops, the skin in an area of the leg may become dark red, brown or purple in color. The texture of the skin may become think, dry and itchy. These symptoms can be localized in one small area on the feet, ankles or legs, or they may encompass the entire lower leg, depending on the progression of the vein disease. Edema may also be present, as the trapped fluid causes noticeable swelling in the feet, ankles or legs. If these underlying vein disease symptoms are left untreated, a venous ulcer may develop.

A venous ulcer is usually red in color and may be covered with yellow fibrous tissue. The border of the ulcer is often irregular and can range in size from a quarter to a grapefruit, or larger in extreme cases. Various symptoms can accompany the open wound, and may include:

  • Swelling
  • Itchy or burning sensation
  • Rash
  • Dry, crusty skin
  • Pain
  • Dark brown or purple skin discoloration
  • Oozing pus

The Vein Care Center Difference

Dr. Paul Larson and the caring staff at the Vein Care Center of Arizona are dedicated to vein disease treatment and management. All of the technologists are registered through the American Registry for Diagnostic Medical Sonography and have advanced credentials in vascular testing. Dr. Larson has two national certifications for the treatment of vein disease. He is Board Certified by the American Board of Venous and Lymphatic Medicine and he also received the advanced venous imaging credential as a Registered Phlebology Sonographer. In addition, Dr. Larson is an anesthesiologist. This training gives him a unique perspective on wound care and pain management, which is not typical for vein specialists. For his patients in Yuma and the surrounding area, this means exceptional treatment with significantly less pain.

If you have open leg sores, leg pain, or varicose veins, you have come to the right place. Dr. Larson and the expert staff at The Vein Care Center of Arizona can help you feel better, regain your mobility and get a new lease on life. Complete this form or call us today at (928) 726-8346 to schedule a consultation.

If an ulcer becomes infected:

  • Redness of the skin around the ulcer
  • Swelling
  • Worsening pain
  • Fever
  • Foul-smelling green or yellow fluid oozing from the sore
  • Significant discharge

Who is at Risk?

Venous ulcers tend to develop in women more often than men and are more prevalent in older individuals. Risk factors include:

  • Age
  • Obesity
  • Inactivity
  • Smoking
  • Consistently standing for long periods of time
  • Pregnancy
  • An injury to the foot or leg
  • Varicose veins
  • Deep vein thrombosis
  • Diabetes
  • Congestive heart failure
  • Peripheral vascular disease
  • Phlebitis, or an inflamed vein

How are they treated?

Quick, effective outpatient visits treat the root cause, not just the symptoms.

Diagnosis

A venous ulcer is most likely a symptom of underlying and advanced vein disease. Thus, we want to start by identifying the problem with an ultrasound study of the legs as well as a consideration of health history and current health status. Additional tests may be performed to diagnose the issue correctly. Once the diseased veins are identified, we will discuss the various treatment options available and recommend the best plan of action for you and your condition. Addressing and treating the root cause of the ulcer will improve circulation, help the wound heal and prevent future ulcers from developing.

Treatment

The first goal in wound care for a venous ulcer is to improve blood circulation in the legs. Elevate the affected area several times a day, consistently wear compression bandages or stockings and walk daily. These activities will promote blood flow and help stop blood from pooling in the lower extremities. Dr. Larson may also remove dead tissue from the open wound, which will remove any surface contaminants and help the sore heal faster. If the tissue surrounding the ulcer becomes infected, medication may be prescribed to help eliminate the infection. In extreme cases where the wound is particularly large or not healing, skin grafting may be necessary to restore the skin.

Prevention

Treating diseased veins is the most important factor in the prevention of venous ulcers. However, other precautions can be taken to reduce the risk of developing skin ulcers, including:

  • Daily examination of the skin on the legs, ankles and feet
  • Not sitting or standing for long periods of time
  • Avoid sitting with legs crossed
  • Stop smoking
  • Exercise daily
  • Elevate legs when sitting or resting
  • Avoid tight-fitting clothing
  • Wear comfortable footwear, free of pressure points
  • Protect feet and legs from injury and infection
  • Avoid extreme temperatures
  • Wear medical-grade compression garments

The Vein Center of Arizona offers patients a wide variety of treatment options:

Comprehensive Treatment Plan

Developing a comprehensive treatment plan follows a thorough assessment. The assessment will normally consist of a review of your venous symptoms, a visual inspection of your problems and a thorough review of your history. The assessment completed by Dr. Paul Larson, supplemented by the diagnostic ultrasound if indicated by a registered vascular technologist will aid in the process.
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Conservative Management

Before seeking out a surgical or non-surgical treatment for varicose veins and other uncomfortable vein disorders, doctors may recommend conservative management techniques for patients. Conservative treatments may be required by an insurance company before other treatments can be considered.
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Radiofrequency Ablation (RFA)

Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.
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Endovenous Laser Treatment

Endovenous Laser Treatment for the elimination of unhealthy varicose veins is the gold-standard for minimally invasive treatment of varicose veins. EVLT uses laser energy, which is a highly concentrated beam of light. They work by delivering this light energy to the tissue that is targeted with extreme precision, so as not to damage the surrounding tissue.
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Sclerotherapy

Sclerotherapy is the primary treatment for spider veins and small superficial varicose veins that usually appear on the legs. They less commonly appear on other parts of the body. Sclerotherapy involves the injection of a chemical solution into a targeted spider vein or a reticular vein through a very fine needle.
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Foam Sclerotherapy

Foam sclerotherapy is a minimally invasive technique for men and women to eliminate unsightly varicose veins and spider veins. The procedure involves injecting a foam sclerosant in a blood vessel to close it. The blood reroutes itself through healthy veins, restoring more normal blood flow.
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Ambulatory Micro-Phlebectomy

Also known as ambulatory phlebectomy, this is a procedure that can be performed in the office and is commonly performed at the time of endovenous ablation. The procedure is intended to remove larger bulging varicose veins near the skin surface.
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Real Results.

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