Veins are responsible for carrying deoxygenated blood back to the heart from various body tissues. The venous system operates at relatively low blood pressure, relying on the contraction and expansion of skeletal muscles to propel blood past the one-way valves in the veins on its way back to the heart. The circulatory system relies on this pressure gradient to push blood through the arteries and into the veins. Any disturbance in this mechanism can lead to venous skin ulcers
Venous skin ulcers, also referred to as stasis, insufficiency or varicose ulcers are the result of malfunctioning venous valves causing pressure in the veins to increase. Venous skin ulcer is the most common etiology of lower extremity ulceration. It account for 80% of lower extremity ulceration.
Venous skin ulcers can be of 8 categories according to the CEAP classification (standing for Clinical signs, Etiological classification, Anatomical distribution and Pathophysiological dysfunction). The most important among them is active venous skin ulcer and healed venous skin ulcer
Active Venous Skin Ulcer
The classification C6 shows the active venous skin ulcers, often accompanied by trophic changes. It is the last stage with full-thickness loss of skin resulting from an accumulation of cellular metabolic waste pr and the capillary blood supply loss.
Venous Healed Skin Ulcer
The category C5 represents healed ulcer with trophic changes. Once healed, a venous skin ulcers is always a weak point in terms of recurrence of a venous skin venous skin ulcers.
According to one of the research study, the major underlying causes of venous skin ulcers in India are filariasis, tuberculosis, diabetes and atherosclerosis (hardening of vessels due to fat deposits). Furthermore, poor local hygiene adds to the problems of venous skin ulcers healing and risk of complications like infection also increases.
Causes of Venous Skin Ulcer
The root of the problem is increased pressure of blood in the veins of the lower leg. This causes fluid to ooze out of the veins beneath the skin. This causes swelling, thickening and damage to the skin. The damaged skin may eventually break down to form an ulcer.
The increased pressure of blood in the leg veins is due to blood collecting in the smaller veins next to the skin. The blood tends to collect and pool because the valves in the larger veins become damaged by a previous blood clot (thrombosis) in the vein or varicose veins. Gravity causes blood to flow back through the damaged valves and pool in the lower veins. Some of the main causes of venous skin ulcers include:
- Congestive Heart Failure
- Varicose veins
- Deep Venous Thrombosis
- Diabetes Mellitus
- Peripheral Vascular Disease
- Skin infection
- Bone Fracture
- Knee or Hip replacement surgery
- Soft tissue sarcomas
- Tumors or cancers
Symptoms of Venous Skin Ulcers
Venous skin ulcers are open, often painful, sores in the skin that take more than a month to heal. he first sign of a venous skin ulcer is skin that turns dark red or purple over the area where the blood is leaking out of the vein. The skin also may become thick, dry, and itchy. They usually develop on the inside of the leg, just above the ankle. If you have a venous venous skin ulcers, you may also have:
- Swollen ankles (edema)
- Discoloration and darkening of the skin around the ulcer
- Hardened skins around the ulcer
- Leg swelling, heaviness and cramping
- Aching, itching or tingling in your legs
- Red, flaky, scaly and itchy skin
- Swollen and enlarged veins (varicose veins)
- Unpleasant and foul-smelling discharge from the ulcer
- High temperature (fever)
- Worsening pain
If the wound becomes infected, the infection may cause an odor and pus may drain from the wound. The area around the wound also may be more tender and red.
Precautions of Venous Skin Ulcer
People most at risk of developing a venous venous skin ulcers are those who have previously had a venous skin ulcers. You can help reduce your risk of developing a venous venous skin ulcers in several ways, such as:
- Wearing a compression stocking
- Losing weight
- Taking care of your skin
- Quit smoking
- Eliminate alcohol use from life
- Manage underlying diseases
- Consume healthy diet
- Exercise regularly
- Avoid sitting or standing for extended periods of time
- Avoid crossing legs while sitting
- void extreme temperatures
Home Remedy for Venous Skin Ulcers
A variety of home remedies and treatments may continue at home to encourage healing of the Venous Skin Ulcer. There are many natural remedies for venous skin ulcers that help to control the symptoms and cure them. The home remedies for venous skin ulcers outlined below might provide relief from swelling, pain, and itching:
- Lift your legs above the level of your heart as often as possible. For example, lie down and then prop up your legs with pillows.
- Wear compression stockings or bandages. These help prevent blood from pooling in your legs.
If your venous skin ulcer is due to the varicose veins compression therapy is frequently the first and most conservative step in its management. Compression stockings work simply by squeezing the leg, thereby reducing the amount of blood and pressure in the veins. Lumino Cielo Copper Compression stockings are based on graduated pressure mechanism that helps you to increase or decrease the pressure gradients. Its knee length design is highly suitable for Indian weather that seems to be much warmer as compared to the western environment. Lumino Cielo is providing many other stockings like Flamingo Varicose Vein Stockings that are stretchable and provide adequate pressure to alleviate your symptoms.
- Flax seed also provides good remedial measures for venous skin ulcers. To use it as a home remedy, flax seed must be ground and put into hot water to make a paste. Then it should be applied on the wound. The affected area should be sealed with plastic, and the pack has to be left overnight. Regular application of the pack helps to cure venous skin ulcers.
- Honey is one of the best home remedies for wounds, burns, skin lesions and venous skin ulcers. A regular application of honey on the venous skin ulcers can precipitate the healing process and prevent bacterial or viral infection.
- Chamomile tea is a good natural cure for venous skin ulcers. Alternately, the patient can make a pack by grounding chamomile flower in hot water and place the pack on the venous skin ulcers. The pack needs to remain on the affected area overnight. This is an extremely effective home remedy for venous skin ulcers.
- Applying tea tree oil to the affected area provides a barrier that prevents any bacterial or viral infection from developing.
Treatment of Venous Skin Ulcer
Treatment for a venous leg ulcer must begin with cleaning the wound well to remove any dead tissues. Since ulcers heal better when they are covered, you will need to dress the wound well and change the dressing on a weekly basis. With appropriate treatment, most venous leg ulcers heal within three to four months.If your ulcer doesn’t heal within a few months, your physician may advise other treatment, such as:
- Medicines like antibiotics, anti-inflammatory etc.
- Topical Ointments
- Hyperbaric oxygen (oxygen delivered at high pressure) is sometimes used when facilities are available.
- A skin graft may be advised for a large ulcer, or for one that does not heal well.
- Surgery for varicose veins or other vein problems is advised in some cases. This may correct back pressure of blood pooling in the veins and allow an ulcer to heal.
- Physical therapy to improve circulation, relieve edema, reduces pain improve activity of daily livings etc.