What is a venous ulcer?
Venous ulcers are a series of changes in the skin and occur when blood concentrates in the veins of the lower legs, especially in the inner ankles. They are also the last level of venous insufficiency.
What are the symptoms?
Among the general symptoms of venous ulcers are continuous pain or heaviness in the legs that are aggravated when standing. In the early stages, the skin of the ankles and lower legs may gradually develop brown spots.
If the area is rubbed, the skin may become irritated, split, redden or swell with crusting or oozing. Over time, some changes may become chronic.
Possible symptoms:
- Varicose veins.
- Dermatitis-venous eczema.
- Lipodermatosis-sclerosis.
- White atrophy.
- Ochre hyperpigmentation.
- Edema.
- Palpation of pulses.
Tests for venous ulceration
First, a physical examination of the extremity will be performed. As complementary tests, a venous duplex echo-Doppler, Doppler scanning, calculation of the ITB index or a biopsy of the lesion may be required.
Causes of venous ulceration
Venous ulcers arise after a skin lesion occurs in the dilated wall of a varicose vein due to venous stagnation of blood or insufficient nutrition of the skin.
The most common cause in adults is venous insufficiency which usually affects the inner part of the leg, while arterial ulcers usually affect the lateral outer part.
Can they be prevented?
To avoid its appearance, it is important to take preventive measures, especially in those people who are predisposed to suffer venous dilatations: take careful care of the feet, maintain an extreme cleanliness, ensure a good hydration of the skin, among others.
In addition to maintaining a proper diet, take baths in the legs alternating cold water and hot water ending with cold and avoid exposure to high temperatures. The important factor is to control the causes of peripheral edema.
What is the treatment?
The treatment of the ulcer once it has formed will depend on the case, but it will normally be aimed at reducing the edema or swelling caused, as well as the pressure in the veins. In addition, the area should be protected with bandages to prevent infection, which should be treated with antibiotics.
As general measures, it is recommended to wear elastic or rest stockings to reduce swelling, avoid standing or sitting for long periods of time and keep the leg raised when sitting. The specialist may also suggest the application of moist dressings, topical steroid creams or ointments.
Treatments for venous ulcers
There are different ways to treat venous ulcers.
Locally:
- Analgesics.
- Clean the ulcer with saline and polyhexanide-betaine,
- Removal of necrotic tissue with sharp, enzymatic or autolytic debridement.
- With infection, use systemic antibiotic,
- Change bactericidal dressing regularly.
- Hygiene and protection using moisturizing skin emulsions on perilesional skin and atrophic areas.
- Do not abuse topical corticosteroids.
In general:
- Treat pain.
- Treat risk factors.
- Rest.
- Watch postures.
- Use therapeutic compression.