Venous Ulcer: Treatment, Procedure, Cost and Side Effects

Venous Ulcer is often referred to as venous insufficiency ulceration, stasis ulcers. It is also known as stasis dermatitis, varicose ulcers, or ulcus cruris.

Venous Ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs.They usually develop on the inside of the leg, just above the ankle. They are the major occurrence of chronic wounds, occurring in 70% to 90% of leg ulcer cases. The most common treatment is a compression bandage or stocking. The pressure should improve the blood circulation in your leg, boosting your body’s ability to heal the sore.

The main aim of the treatment is to create such an environment that allows skin to grow across an ulcer. In the majority of cases this requires finding and treating underlying venous reflux and National Institute for Health and Care Excellence (NICE) recommends referral to a vascular service for anyone with a leg ulcer that has not healed within 2 weeks or anyone with a healed leg ulcer. Various types of Treatment include Compression Therapy, Simple medications, Skin grafts and artificial skin and Surgery. With appropriate treatment, most venous leg ulcers heal within three to four months. Venous Ulcer treatment should always be carried out by a healthcare professional trained in compression therapy for leg ulcers. Usually, this will be a practice or district nurse.

Antibiotics may also be used if the ulcer becomes infected, but they don't help ulcers to heal. However, unless the underlying cause of the ulcer is addressed, there's a high risk of a venous leg ulcer recurring after treatment.Underlying causes could include immobility, obesity, previous DVT, or varicose veins.

A Venous Ulcer is diagnosed by seeing if there is any swelling in your ankles or discoloured or hard skin.The practice nurse will also try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as Diabetes, deep vein thrombosis (DVT),injury or surgery in the affected leg, a previous leg ulcer.

The nurse may also examine your leg, both when you're standing up and lying down. Varicose veins will be more obvious when you're standing up, and it will be easier to look at the ulcer when you're lying down. The first step is to remove any debris or dead tissue from the ulcer and apply an appropriate dressing. This provides the best conditions for the ulcer to heal.A simple, non-sticky dressing will be used to dress your ulcer. This usually needs to be changed once a week. Many people find they can manage cleaning and dressing their own ulcer under the supervision of a nurse.Compression therapy is also used for venous leg ulcers and can decrease blood vessel diameter and pressure, which increases their effectiveness, preventing blood from flowing backwards.Compression is applied using elastic bandages or boots specifically designed for the purpose.

There are many different types of bandage or elastic stockings used to treat venous leg ulcers, which may be made in two, three or four different layers.The application of a compression bandage is a skilled procedure and they should only be applied by trained healthcare staff.The bandage is changed once a week, when the dressing is changed.The pain will lessen once the ulcer starts to heal, but this can take up to 10-12 days.

Venous leg ulcers are estimated to affect around 1 in 500 people in the UK, although they become much more common with age. It's estimated that around 1 in 50 people over the age of 80 has one.You're more at risk of developing one if you've previously had deep vein thrombosis (DVT) or find it difficult to walk because of a problem like osteoarthritis, leg injury, obesity, paralysis.

If you have a venous leg ulcer, you may also have hardened skin around the ulcer, which may make your leg feel hard or even resemble the shape of an upside-down champagne bottle or aching or swelling in your legs, or Red, flaky, scaly and itchy skin on your legs or an unpleasant and foul-smelling discharge from the ulcer or if you are having a heavy feeling in your legs.A venous leg ulcer can be susceptible to bacterial infection which can be observed by a green or unpleasant discharge coming from the ulcer, a high temperature (fever).

Sometimes, other diseases like angina, cerebral vascular accident, depression, malignancy, myocardial infarction, pneumonia are inversely associated with venous ulcer .These have to be treated under separate conditions with a different set of treatments and seeking out treatment for venous ulcer will not help with your condition. Hence, proper consultation has to be made to become aware of the treatment required for the specific disease.

As is the case for most of the treatments, there are certain side effects which can be seen. Some of them include dullness, fatigue and feeling drowsy after the treatment is taken.This is natural as the antibiotics or other medications are designed such a way to make the patient sleep well.So that ,there is adequate rest taken and proper care is monitored.There can sometimes be itching too which is common.

You should return to your nurse once a week to have your dressings and compression bandages changed. They will also monitor the ulcer to see how well it is healing. Once your ulcer is healing well, you may only need to see your nurse once a month.Once a leg has suffered a venous ulcer, there is a one in four chance of further ulceration developing within the next two years. The most effective method of preventing this is to wear a graduated elastic medical compression stocking at all times when you are out of bed. Your nurse will help you find a stocking that fits correctly and which you can manage yourself.

Meanwhile, Regularly exercise your legs by moving your feet up and down, and rotating them at the ankles. This can help encourage better circulation.You should Stop smoking and moderate your alcohol consumption. This can help the ulcer heal faster and Be careful not to injure your affected leg, and wear comfortable, well-fitting footwear.Wear your compression bandage exactly as instructed by your nurse. If you have any problems with it, do not remove it yourself.

A leg ulcer is a long-lasting wound on your leg or foot that takes more than six weeks to heal.If your venous leg ulcer does not heal, even after two to three months of treatment, you will need to be referred for specialist treatment to find out why. The specialist will be able to arrange further investigations such as colour duplex ultrasound imaging or biopsy of the ulcer to determine what is preventing your ulcer from healing.

There is no approximate cost figure available for the treatment in India and If there is no requirement of surgery as recommended by the specialist.Then, medicines like Pentoxifylline can be taken which costs in the range from Rs48 to Rs100.

There is a no permanent cure as such to heal Venous ulcer and has a significant chance that they will recur after healing, one study found that up to 48% of venous ulcers had recurred by the fifth year after healing.However treatment with local anaesthetic endovenous techniques suggests a reduction of this high recurrence rate is possible.Therefore, the best way to heal is by wear compression stockings at all times when you're out of bed and try to keep active by walking regularly. Sitting & standing still without elevating your legs can make venous leg ulcers and swelling worse.