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Venous Stasis Ulcer

Last reviewed by Dr. Raj MD on January 12th, 2022.

What is Venous Stasis Ulcer?

These are wounds that occur in your legs and are the major reason that chronic wounds, which is a wound that will not heal in a set of stages in an orderly manner and an amount of time that is predictable the way most normal wounds do, happen in seventy to ninety percent of venous stasis ulcers.

These types of ulcers are also known as ulcus crusis, stasis ulcers, leg ulcers, or varicose ulcers. This type of ulcer affects approximately five hundred thousand to six hundred thousand people in the United States each year along with the lost of two million work days.

Treatment costs for venous stasis ulcer is approximately three billion dollars each year in the United States. Of all leg ulcers seen, this one is the most common.

Venous stasis ulcer is usually found in the lower leg on the inner part that is just above your ankle but can occur anywhere on the leg below the knee and can affect one or both legs. There may even be more than one venous stasis ulcer on the leg. As a person ages there is more of a chance for developing this type of ulcer.

Venous Stasis Ulcer Symptoms

Normally a venous stasis ulcer will present itself as an open sore, which will usually be in an area on the leg that is already a red to brown discoloration which may have been there for a long time. Other symptoms may include:

The area will most likely be swollen.
Before the formation of the venous stasis ulcer the skin may have been itchy and flaky, which is known as stasis dermatitis. This is eczema of your skin because of blood that is perfusing through and settling into layers of your skin. When this happens it breaks down the skin and deposits melanin and hemosiderin, which is the blood seeping into your skin and staining your skin because the venous system is unable to pump it up to your heart adequately.
The base is usually red but there may be a white to yellow tissue that overlies the base. This is known as fibrous tissue which is basically scar tissue that did not promote healing.
There may be a drainage that comes from the wound that can be clear to yellow in color.
The skin around the venous stasis ulcer may appear swollen, shiny, and tight with a tinge of reddish-brown and the skin may appear thin.
It may be itchy.
It may feel warm or hot.
The pain associated with a venous stasis ulcer will vary and can be a burning or aching sensation along with a fullness or heaviness in the leg.
There may be varicose veins present.
There may be mild to severe edema of the lower leg, ankle, and foot.
Having sensations of fatigue.

Causes

The cause of venous stasis ulcer is a poor function of your venous system which simply means that your legs are not pumping blood back to your heart properly. Other causes may include:

Varicose veins resulting from pregnancy.
Being obese
Hereditary factors.
Having a history of blood clots known as phlebitis.
Having a history of trauma to your lower leg which some physicians consider the number one source of these type of ulcers.
Having an inflammatory disease like lupus, sclerodema, or vasculitis or other rheumatological disease.
Malignancies
Having a history of lying or sitting in one position for too long of a period of time.
Being a paraplegic because they do not have the pumping ability in their calf muscles.

Treatment

The treatment that is used for venous stasis ulcer depends on the severity of the ulcer. To help with the pain simply elevating the leg for an hour will help bring relief.

Usually the standard treatment involves using compression of the leg that is affected to help minimize swelling because if you do not get rid of the constant swelling you are reducing dramatically having the wound close. The types of compression that may be used include using ace bandages or other multilayer compression wraps or compression stockings.

If a person cannot stand compression over the venous stasis ulcer because of the pain physicians have used in recent years a medication called Pentoxifylline (Trental). The medication can help to improve the circulation down to your feet and can help improve the wound environment so that it will heal faster. The physician may use this medication alone or with compression therapy.

They will usually remove the dead tissue in order to better treat the venous stasis ulcer because the dead tissue can harbor bacteria and when the dead tissue is removed it will help to clear up the infection. If the wound is not infected, removing the dead tissue will help reduce the chances of it becoming infected.