A venous stasis ulcer occurs in the lower legs, usually between the knee and ankle. They can cause pain and swelling and require treatment from a medical professional.

Venous stasis ulcers are a type of ulcer found on the legs. These ulcers form as a result of blood flow problems in the leg veins. Other names include venous ulcers or stasis ulcers.

A venous stasis ulcer may cause pain, swelling, and itching.

This article looks at what a venous stasis ulcer is, the symptoms, causes, treatment options, prevention, and outlook.

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The National Cancer Institute defines an ulcer as a break in the skin, in the lining of an organ, or on the surface of a tissue. They say these occur when there is an inflamed, dead, or shedding surface.

A venous stasis ulcer occurs on the leg. It is a common problem in the United States and affects approximately 1% of the population. Research states this prevalence rises to 3% in individuals over the age of 65.

It also accounts for 80% of ulcers in the lower part of the body. A venous stasis ulcer is present on the leg. It often forms on the inside, between the knee and ankle.

Who gets them?

Research from 2017 states that as well as affecting the over-65 population, venous stasis ulcers may also affect individuals with:

  • previous history of edema in the legs
  • varicose veins
  • blood clots in the leg veins

A venous stasis ulcer, like other ulcers, will need treatment to heal properly.

A person with a venous stasis ulcer will have an open and painful sore on the leg. This will take over 2 weeks to heal.

As well as these open sores, other symptoms of venous stasis ulcers, according to the National Health Service (NHS) in the United Kingdom, may include:

  • swelling in the ankles and legs
  • discolored, darkened, and hardened skin surrounding the ulcer
  • a heavy or aching feeling in the legs
  • flaky, scaly, or itchy skin
  • swollen and enlarged leg veins

Healing of venous stasis ulcers may take months or years, and they are also prone to reoccurring.

A person may experience the following as a result of their leg ulcers:

  • pain
  • social isolation
  • sleep disturbances
  • depression
  • time away from work
  • financial difficulties

A person develops a venous stasis ulcer due to valve damage to the leg veins. The valves control the return of blood from the legs to the heart and affect the blood pressure in the veins of the legs.

High pressure can cause damage to blood vessels in the legs, creating circulation problems and causing the skin to become delicate. This means a person is more susceptible to breakage of the skin.

Other risk factors for developing venous stasis ulcers include:

  • Varicose veins: This is where a person has enlarged leg veins. This causes a buildup of blood which can contribute to ulcer development.
  • Chronic venous insufficiency: A condition causing blood to pool in the lower legs, resulting in swelling. This can place pressure on the skin, and ulcers may form as a result.
  • Obesity: Carrying extra weight can place pressure on the lower legs.
  • Walking difficulties: When a person cannot walk properly, the muscles become weak, resulting in circulation problems. This is why a person’s risk of venous stasis ulcers increases as they age, as moving around may become more difficult.
  • Deep vein thrombosis: This produces blood clots in the legs and results from valve damage to the veins. This valve damage can also cause ulcers.
  • Previous leg injury: A person with a fracture or leg injury may develop deep vein thrombosis or have difficulty moving around, putting them at risk for ulcers. Additionally, those who have recently had surgery that has affected their movement ability may be at risk.

The goals of treatment for venous stasis ulcers are to reduce swelling, stimulate wound healing, and prevent the ulcer from reoccurring.

Wound dressing

A person will first have the wound cleaned and dressed. A doctor will show a person how to change these dressings themselves as they may need to change them 1-3 times a week.

Compression therapy

This is the standard treatment for venous stasis ulcers.

A person will often have a compression bandage or stocking placed on the ulcer. This compresses the legs and encourages blood flow from the legs and back toward the heart.

This can encourage a decrease in swelling, reduce pain, and encourages wound healing. However, compression therapy may be painful at the beginning of treatment.

Research recommends a person with a leg ulcer have compression therapy for at least 1 hour per day and 6 days a week. This may also help to prevent reoccurrence.

Exercise

Exercising may help to promote healing. A person may also receive physical therapy. A physical therapist can recommend certain exercises to help with recovery in these sessions. This may include ankle exercises and light walking.

Medications

A person may also receive medication alongside other therapies to manage the pain and inflammation from a venous stasis ulcer. Examples of medications may include:

  • aspirin
  • statins
  • antibiotics

Surgery

In some severe cases, a person may need a skin graft or other forms of surgery to repair the skin.

A person will often receive this treatment if the ulcers keep reoccurring or do not go away following other treatments.

Management

A person should also ensure they manage the wounds themselves by:

  • changing the dressing and cleaning the wound when necessary
  • avoiding skin-sensitive products
  • wearing compression stockings
  • using topical treatments as recommended by a doctor
  • taking medications as prescribed by a doctor

A person can try to prevent venous stasis ulcers by avoiding leg vein problems. Some ways in which they can avoid these problems include:

  • maintaining a moderate weight
  • avoiding smoking
  • elevating legs when possible

If a person knows they are at risk for developing a venous stasis ulcer, they may wish to sometimes wear compression stockings. This will help improve blood flow, avoid swelling, and reduce the risk of leg ulcers.

With the appropriate treatment, venous stasis ulcers can disappear. However, they will not go away of their own accord and may reoccur.

The pain caused by a venous stasis ulcer can impair a person’s quality of life and impact their daily activities. This is why it is important for a person to consult a doctor as soon as they notice a leg ulcer developing.

Venous stasis ulcers occur on the lower half of the legs, usually between the knee and ankle. This can result from damage to the valves in the leg veins.

These ulcers can cause pain and swelling and will not go away of their own accord. They are treatable and require intervention from a doctor.

Treatment options include wound dressings, compression therapy, exercises, medications, and self-management. In severe cases, surgery or skin grafts may be essential.

A person should consult their doctor as soon as they notice an ulcer developing.