Venous ulcer

Venous ulcers (sores that develop on your legs) can be challenging to treat. You may need to see specialists in vascular medicine and wound care. At Atrium Health Floyd and Harbin Clinic, you’ll find expertise and guidance to help you heal and prevent new sores.

What is a venous ulcer?

Venous ulcers are open sores that develop when blood in your legs doesn’t travel back to your heart as it should. Because ulcers can be slow to heal, it’s important to identify and treat them as soon as possible.

Causes of venous ulcers

Venous ulcers are caused by venous insufficiency, a condition in which the valves inside your leg veins become weak or damaged.

Valves prevent blood from flowing backward. When they don’t work properly, pressure in the veins increases and blood circulation slows. Cells and tissues don’t get the nutrients and oxygen they need and die, forming sores in the affected areas.

In some cases, venous ulcers can occur near varicose veins, which are also related to venous insufficiency.

Venous ulcer symptoms

Venous ulcers are shallow, irregularly shaped wounds that usually develop just above the ankle. The surrounding skin may be discolored and tight or warm to the touch. If the sore becomes infected, it may produce pus and a foul odor.

Before the sore develops, you may notice other symptoms in your legs, such as:

• Aching and cramping
• Itching and tingling
• Swelling and heaviness
• Skin discoloration, hardening and thickening

Venous ulcer diagnosis

Diagnosis is usually based on a visual exam of your legs and review of your medical history. Your doctor may also order a duplex ultrasound to measure blood flow in your legs.

Venous ulcer risk factors

Having a history of venous insufficiency or varicose veins increases your chance of developing venous ulcers. Other risk factors include:

• Female sex assigned at birth
• History of deep vein thrombosis (DVT)
• Leg injuries, such as fractures, burns and muscle damage
• Obesity
• Older age
• Pregnancy
• Sitting or standing for long periods of time
• Smoking
• Tall height

Venous ulcer prevention

Early detection of skin changes can help prevent venous ulcers. If you have venous insufficiency with or without varicose veins, check your legs and feet daily. Your doctor will also advise you on how to manage these conditions to avoid venous ulcers and other complications.

Venous ulcer treatment

Treatment starts with basic wound care strategies to promote healing and prevent infection. In general, doctors typically recommend:

• Keeping the area clean, dry and covered, changing the dressing as directed
• Moisturizing the skin around the wound
• Wearing compression stockings over the dressing

Your doctor may suggest lifestyle changes to improve blood flow in your legs, which speeds healing. These strategies include:

• Elevate your feet periodically.
• Quit smoking.
• Maintain a healthy weight.
• Manage other conditions, such as diabetes, high blood pressure and high cholesterol.
• Stay active with regular exercise.

Large, infected or hard-to-heal ulcers may require advanced treatments. Atrium Health Floyd and Harbin Clinic offers comprehensive wound care services, including hyperbaric oxygen therapy and grafting procedures. Our vascular surgeons also offer procedures to treat veins affected by venous insufficiency and improve blood flow.