What Patients Must Know About Venous Stasis Ulcer Treatment
What is an ulcer?
An ulcer is a wound that has not healed in more than four weeks. There are 2 main types of vascular ulcers: Ischemic/arterial ulcers and venous ulcers. A venous stasis ulcer is a wound that is not healing due to the pooling of blood flow in the legs. This backup of blood flow in the veins causes an increased outward pressure applied to the skin. This then erodes away at the skin surface leading to the wound which then becomes an ulcer.
In a vascular practice, part of our mission is to help prevent ulcers from occurring. However, many patients come to us after an open ulcer has occurred. At times, patients have even had ulcers for years before seeking treatment. A patient’s medical conditions can also affect wound healing.
The most common conditions to slow wound healing are diabetes, tobacco use, obesity, cardiovascular disease, and lymphedema. Therefore, the best ulcer treatment is a team approach between the patient and their healthcare providers.
Venous stasis ulcer treatment
The role of a vascular clinic in healing an ulcer is to help investigate the cause of the ulcer. This will consist of performing a detailed history and physical examination. Next, an ultrasound will be performed. Ultrasounds are extremely useful in diagnosing if an ulcer is not healing due to arterial disease or venous insufficiency. In the case of venous stasis ulcers, the ultrasound will map out any veins that are causing the wound to not heal. Next, treatment is initiated. An important first step to treatment is wearing compression stockings. In some cases of venous stasis ulcers, a type of compression called an Unna Boot is applied to the affected leg. This is a type of medicated compression wrap that is changed on a weekly basis and aids in ulcer healing.
Next, targeted vein treatment is initiated. This can consist of treatment for both superficial and deep veins. Superficial veins are the veins located close to the skin surface that cause superficial venous insufficiency. The treatment of these veins is minimally invasive with the treatment goal to close off any refluxing veins. Deep veins are treated in a procedure called a venogram. This is an outpatient procedure where the Common Iliac Vein is investigated and stented to help improve the blood flow leaving the leg. Both superficial and deep venous treatment aim to help blood return out of the leg to help the venous stasis ulcer to heal.
After the ulcer has healed, the skin is never as strong as it was prior to getting the wound. Therefore, it is important to continue to wear compression socks daily so that the wound does not return. It is also important to continue frequently scheduled check-ups with your vascular provider to help prevent an ulcer from reoccurring.
What to expect from CVM?
At the Center for Vascular Medicine, our mission is to help patients with their vascular diseases in a cost-effective and compassionate manner. We specialize in the diagnosis and treatment of venous and arterial diseases in the legs, feet, and pelvis. Our world-class providers are the most experienced in the specialty and work with patients to develop a treatment plan that is custom-tailored to their unique situation.
Typically, this process involves an initial consultation with a possible ultrasound scan at one of our facilities. After reviewing the results of your scan and obtaining a thorough medical history, our providers will discuss the results with you and help you decide on the next steps.
Call to schedule at (301) 486-4690 or fill out a request to consult form.