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