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Venous Ulcer

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What Is a Venous Ulcer?

Venous ulcers (also known as venous stasis ulcers or nonhealing wounds) are open wounds occurring around the ankle or lower leg.

They do not heal for weeks or months, and occasionally persist longer.

Causes of Venous Ulcers

Some issues that can cause venous ulcers include:

  • Venous hypertension
  • Venous insufficiency
  • Varicose veins
  • Blood clots or poor circulation
  • Diabetes, kidney failure, or inflammatory diseases
  • Certain medicines
  • Infections
  • Obesity

Symptoms of Venous Ulcer

There are many signs of venous ulcers, including:

  • Leg swelling and cramping.
  • Dull ache or feeling of heaviness in the leg or calf.
  • Itchiness and tingling, red-colored skin.
  • Signs of pooling blood, including dark red, purple, and brown spots with hardened skin.
  • Skin surrounding the ulcers may be shiny, tight and warm, or hot to the touch.
  • The borders of the ulcers may be unevenly shaped.

What are venous stasis ulcers?

Commonly located on the ankle or calf, venous stasis ulcers are painful and red in color but may be covered with a yellow, fibrous tissue and an irregular border.

Drainage and discharge are possible with venous stasis ulcers. This type of ulcer is common in patients with a history of leg swelling or varicose veins.

Venous Ulcer Diagnosis and Treatment

Doctors at Vascular surgeons at UPMC's Heart and Vascular Institute use duplex ultrasound, a noninvasive test, to diagnose abnormal veins that cause venous ulcers. Part of the UPMC difference is that we actively look for the causes of the ulceration to treat venous pathology and keep the ulcer healed.

After an evaluation of your veins, we recommend a treatment plan based on your needs:

  • Compression
    • Compression of the leg is vital to healing venous wounds.
    • Compression stockings are most commonly used for this treatment.
    • The pressure from the compression dressing counteracts the pressure from the veins of the leg and allows skin to heal.
  • Unna boots
    • A moist gauze applied around the lower leg, from the base of the toes to just below the knee.
    • This gauze then hardens to form a snug boot on the leg.
    • The support from the boot helps improve blood flow in the veins and heal the ulcer.
  • Transparent dressings
    • A clear, plastic-like film applied over the wound.
    • A support stocking is worn over the dressing to help hold it in place and improve circulation in the extremity.
  • Hydrocolloid dressings
    • A dressing applied over the venous ulcer to promote healing.
    • It also helps to remove any nonliving tissue from the wound (debridement).
  • Growth factors
    • Investigational medicines applied to the wound in the hope of promoting the growth of new tissue.
  • Surgery or vein ablation
    • Sometimes minor surgery (wound debridement) or vein ablation (a nonsurgical technique that closes a vein) is used to remove any nonliving tissue that keeps a wound from healing properly. 

Learn More About Venous Ulcers

Visit UPMC's Wound Healing Services for more about venous ulcers.

Or, see the following resources:

UPMC Patient Education Materials

UPMC HealthBeat