Venous Leg Ulcers
The great majority of patients with vein disease experience it as painful and unsightly varicose veins or spider veins. However, approximately 10% of patients with vein disease develop complications such as bleeding, phlebitis, and venous leg ulcer. Venous leg ulcers are extremely painful complications of varicose veins and are usually found on skin near the veins—usually around the ankles.
Causes and Symptoms of Venous Leg Ulcers
Venous Leg Ulcers result from increased pressure within the vein which causes the white blood cells to migrate through the vein wall into the skin. This usually occurs on the inside of the ankle. At first, the skin gradually darkens and thins, and ultimately an ulcer develops. This is considered end-stage vein disease, i.e. the worst case scenario of untreated severe venous insufficiency. Venous leg ulcers can take months to heal and frequently tend to recur if the underlying venous insufficiency is not addressed.
Bleeding can occasionally be severe as large amounts of blood stored in varicose veins can drain quickly through small cuts in small spider veins around the ankles.
Bleeding can usually be stopped by elevating the limb and applying direct pressure. Any episode of heavy bleeding should be evaluated by a physician.
Phlebitis is the formation of a clot in the slow moving blood of varicose veins, which may be precipitated by minor trauma but often occurs spontaneously. These clots are painful and cause tender swollen cords which should be evaluated by a physician. Thankfully, in most instances, the clots are confined to the superficial veins of the skin and are not dangerous, but this must be determined by a physician. Clots extending to the deep venous system are potentially threatening to both life and limb.
“The patient pictured to the right suffered with an open venous leg ulcer for over a year. The ulcer measured over 3 ½ x 2 ½ inches. The “after” picture was taken 8 weeks after a single treatment of endovenous laser ablation. The ulcer is closed after being an open wound for over 12 months. The skin is irreversibly scarred and darkened, but healed. Left untreated, venous leg ulcers have a 50% recurrence rate over the subsequent five years. If underlying venous insufficiency is treated, the recurrence rate is lowered to 15%.”
Venous Leg Ulcer Treatment Options
Venous leg ulcers may require a combination of treatments to address the ulcer itself and treat the underlying vein disease. Typically, we use Endovenous Laser Treatment for venous leg ulcers, which is a laser procedure that lasts less than an hour and requires only a local anesthetic and no incision.
EVLT: Endovenous laser treatment places a laser catheter inside the diseased vein and then targeted laser energy seals the diseased vein(s) shut. EVLT procedures typically last less than an hour and require only a local anesthetic and no incision.
Learn more about EVLT
About East Tennessee Vein Clinic
East Tennessee Vein Clinic was the first dedicated vein clinic in Tennessee and since then Dr. Andrew Douglass has helped thousands have healthy legs that look and feel better.