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What is a Venous Ulcer?

The term venous ulcer means a sore on the leg that is due to chronic venous disease. (CVD) Venous ulcers can be very painful with many inflammatory changes around the ulcer bed. These ulcers are on the lower leg, usually medially just above the medial malleolus (Ankle bone).Venous ulcers can also occur on the anterior or lateral lower leg.

Venous ulcers are related to high pressure in the venous system of the leg. Common causes of high pressure include reflux in the superficial or deep venous system. Reflux means the valves are not working properly and blood return from the leg is not at a normal level. Gradually pressure in the venous system of the leg increases to a high level. When the pressure becomes too high, skin breakdown can lead to an ulcer.

Ulcers affect approximately 1% of the population, and represent the most advanced stage of CVD. The treatment of venous ulcers is to decrease the venous pressure. Traditionally this consisted of compression dressings and wound care. When doing only compression dressings, it may take many months for the ulcer to heal.

If your high venous pressure is secondary to a vessel in the superficial venous system, then procedures such as thermal ablation, MOCA (Clarivein), or foam sclerotherapy of the greater saphenous vein (GSV) or small saphenous vein (SSV), may help relieve the pressure and decrease the time to heal the ulcer.

Another treatment is sclerotherapy using a foam solution to treat the veins under the ulcer bed. This procedure allows for rapid healing (6 weeks – 3 months) compared to conventional compression dressing. Injecting these veins in the ulcer bed is not difficult if done by an Expert in venous disease.

“The main goal in treating venous ulcers is to reduce the high pressure in the veins in the area of the ulcer. When the pressure is reduced the ulcer can heal.”

Ronald Bush, MD, FACS


Author

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Dr. Ronald Bush MD FACS

Medical Director Vein Experts

Dr. Ronald Bush is the Medical Director for Vein Experts