Venous stasis primarily occurs in body regions situated below the heart. Granulation tissue is often visible at the base of the ulcer. For physical reasons, the lower legs are most frequently affected. Ulcers are commonly situated over bony prominences because these sites are more prone to trauma. Still, patients may not associate a VSU with any traumatic event. They are irregularly shaped, shallow cutaneous lesions of varying size. Edematous swelling, erythema and shiny skin consistent with stasis dermatitis may be noted in close proximity to VSU [6]. Lipodermatosclerosis and atrophie blanche are commonly observed [7]. Patients may claim tenderness and dull aching pain in regions affected by VSU. In the case of systemic disorders, symptoms occur bilaterally. In contrast, post-traumatic VSU and similar conditions are generally limited to one leg.

• Leg Swelling

  Mild symptoms may include: Heaviness, burning, aching, tiredness, or pain in your legs Swelling in your feet and ankles Itching over the vein More serious symptoms include: Leg swelling Skin changes, such as: – Color changes – Dry, thinned skin – Inflammation [yourhealthyveins.com]

  Venous stasis (purplish skin) ulcers are common in patients who have a history of leg swelling, varicose veins or a history of blood clots in either the superficial or deep veins of the legs. [premierveincenter.com]

  This leakage leads to a buildup of blood cells, fluid, and proteins, and that buildup causes your legs to swell. This swelling is called peripheral edema. [healthline.com]

  Signs and symptoms can include: Leg swelling, heaviness, and cramping Dark red, purple, brown, hardened skin (this is a sign that blood is pooling) Itching and tingling Shallow sore with a red base, sometimes covered by yellow tissue Unevenly shaped borders [athensveins.com]

• Disability

  Without proper treatment, an ulcer may grow progressively larger until it encircles the leg and causes severe disability for the individual. These ulcers affect industry because they are a major cause of lost work time. [sierravein.com]

  Without proper treatment, an ulcer may grow progressively larger until it encircles the leg and cause severe disability for the individual. These ulcers affect industry because they are a major cause of lost work time. [lvradiology.com]

  […] and Health) 2009AA ICF-CY (International Classification of Functioning, Disability and Health for Children and Youth) 2009AA ICNP (ICNP) 2015AB ICPC (ICPC) 1998AA ICPC2EDUT (ICPC2E Dutch) 2004AB ICPC2EENG (ICPC2E) 2004AB ICPC2ICD10DUT (ICPC2-ICD10ENG [doctor.am]

  The condition is said to cause some amount of disability to 2 to 5% of the total population. Statistics show that about 70 to 90% of chronic wound cases are due to venous stasis ulcer. [howshealth.com]

  Surgical reconstruction of deep vein valves may be offered to selected patients with advanced severe and disabling CVI who have recurrent VSUs. The literature shows that surgical vein stripping isn’t superior to medical management. [woundcareadvisor.com]

• Leg Edema

  Leg edema tends to be unilateral or asymmetric; bilateral symmetric edema is more likely to result from a systemic disorder (eg, heart failure, hypoalbuminemia) or certain drugs (eg, calcium channel blockers). [merckmanuals.com]

  If a Venous Stasis Rash or a great deal of leg edema and weeping are present, one must consider use of our Venous Stasis Relief Spray initially. [progressivedoctors.com]

  Advise them to: • elevate their legs above heart level for 30 minutes three to four times daily (unless medically contraindicated), to minimize edema and reduce intraabdominal pressure. [woundcareadvisor.com]

• Wound Infection

  Complications consisted of postoperative thrombophlebitis (2%), wound infection (2%) and wound infection with ulcer necrosis (1.5%). These all responded to conservative management. [ncbi.nlm.nih.gov]

  Alternatively, the wound itself may be infected, without systemic effects. Take steps to lower the bacterial count of these wounds, including topical methods to encourage wound healing. [emedicine.medscape.com]

  The main complication of stasis ulcers is infection. Wound infection can impair the healing process. Bacteria colonise nearly all leg ulcers, but systemic antibiotics are not required unless clinical signs of infection are present. [dermnetnz.org]

  Wound infection is diagnosed when a culture shows greater than 100,000 organ-isms/mL, but culture is not appropriate unless clinical signs of infection are present. 1,13,23 This patient’s wounds exhibited edema, but not bogginess. [nursing.advanceweb.com]

• Severe Pain

  pain even to lightest touch so for them compression unaboots are torture and ace wrap falls down. some have tolerated setapress dressing. article: compression therapy in wound healing scabs are the body's way of bandaging itself. they form to protect [allnurses.com]

• Venous Insufficiency of Leg

  You are here: Home » Case Studies » Case Study – Chronic Venous Stasis Ulcer Right Leg This is a 76 y. black female presents with a chronic venous stasis ulcer right leg. [woundcare.org]

  Typically, poor circulation is the result of a chronic (long-term) condition called venous insufficiency. Venous insufficiency occurs when your veins have trouble sending blood to your heart. [healthline.com]

  Chronic venous insufficiency and venous leg ulceration. J Am Acad Dermatol. 2001;44(3):401–421. 14. Etufugh CN, Phillips TJ. Venous ulcers. Clin Dermatol. 2007;25(1):121–130. 15. Phillips TJ, Dover JS. Leg ulcers. [aafp.org]

• Skin Ulcer

  Symptoms of Venous Stasis Leg Ulcers Early signs of venous ulcers include darkened or discolored skin around the ankle, or skin that feels leathery or waxy to the touch. [goldmanveininstitute.com]

  There are two other types of skin ulcers that can happen on the lower leg or feet. They are different from venous skin ulcers. Arterial skin ulcers are less common than venous skin ulcers. [northshore.org]

  As a result skin breakdown may occur resulting in an open ulcer of the skin that often drains moderate to large amounts of fluid. [mmcoakridge.com]

  A venous skin ulcer can be identified by the darkening of the skin (dark red or purple) where the ulcer is forming. If left untreated, an ulcer can form, which can become infected. [bedsorefaq.com]

• Hyperpigmentation

  Signs and symptoms of venous ulcers Symptoms may show up even before an ulcer forms, such as: Swelling, heaviness or cramping in the legs Hardening or thickening of the skin (lipodermatosclerosis) Dark red, purple or brown discoloration (hyperpigmentation [veindirectory.org]

  Venous stasis dermatitis consists of reddish brown hyperpigmentation, induration, venous ectasia, lipodermatosclerosis (fibrosing subcutaneous panniculitis), and venous stasis ulcers. [merckmanuals.com]

  Frequently the surrounding tissue has other signs of venous insufficiency, such as hyperpigmentation, pitting or woody edema, excess collagen deposition and fibrosis. [centerforvein.com]

• Skin Discoloration

  This back-up of blood leads to skin discoloration, skin thickening, swelling, and possible ulceration. Venous ulcers are located below the knee and are primarily found on the inner part of the leg, just above the ankle. [premierveincenter.com]

  Symptoms of chronic venous stasis disease may include any or all of the following: Swelling in legs and ankles, skin discoloration (brown, red or bluish) Dry scaly itchy skin Aching or feeling of tiredness in legs that is relieved by elevating legs Prominent [mmcoakridge.com]

  Signs Medial malleolus most often affected Irregular, flat border Associated findings Dependent Edema Varicose Vein s Purpura Red-brown Skin Discoloration Venous dermatitis ( Eczema tous changes) VII. Differential Diagnosis VIII. [fpnotebook.com]

  More advanced stages can result in skin discoloration, swelling legs, and venous ulcers. [vascareclinics.com]

• Pruritus

  Pruritus may accompany skin changes. [merckmanuals.com]

  These dressings are also believed to provide symptomatic relief, such as decreased pain and pruritus. Dressings that deliver substances active in the healing process, such as growth factors, have been the subject of much recent investigation. [emedicine.medscape.com]

• Brown Skin Discoloration

  Signs Medial malleolus most often affected Irregular, flat border Associated findings Dependent Edema Varicose Vein s Purpura Red-brown Skin Discoloration Venous dermatitis ( Eczema tous changes) VII. Differential Diagnosis VIII. [fpnotebook.com]

• Fracture

  Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. [foot-pain-explained.com]

  […] thrombosis ) Blockage of the lymph vessels, which causes fluid to build up in the legs Older age, being female, or being tall Family history of venous insufficiency Obesity Pregnancy Smoking Sitting or standing for a long periods (usually for work) Fracture [medlineplus.gov]

  These include: Increasing age Previous deep venous thrombosis (DVT) (a blood clot in the deep veins) Obesity Lower limb fracture, surgery or injury Immobility High blood pressure Standing upright for long periods Multiple previous pregnancies Varicose [dermnetnz.org]

  Previous fracture, trauma or surgery. Family history of venous disease. Symptoms of venous insufficiency - for example, pains or heaviness in the legs, aching, itching, swelling, breakdown of the skin surface, pigmentation, eczema. [patient.info]

• Calf Pain

  The symptoms of stasis dermatitis include: skin discoloration itching scaling ulcers You may also experience symptoms of venous insufficiency, including: leg swelling calf pain calf tenderness a dull ache or heaviness in your legs that gets worse when [healthline.com]

• Ankle Pain

  I found you based on my ankle pain search and am happy to realize that there may be a relatively simple cause and solution.... Natalie unknown location ...Thanks for your fantastic service. [foot-pain-explained.com]

• Foot Pain

  My foot pain may not rule the rest of my life after all! I believe I'll make a sign that reads, "THE END IS NEAR!" [foot-pain-explained.com]

• Leg Cramp

  Venous insufficiency is more likely to be present in patients who have vein-related symptoms such as chronic pain and discomfort, leg heaviness, leg swelling, or leg cramping. [phlebology.org]

Leg ulcers are very common and are diagnosed clinically. Anamnestic data generally support the diagnosis of VSU. Because these ulcers occur in patients suffering from chronic disease, affected individuals typically have a medical history of venous insufficiency, varicose veins, phlebitis and/or eczematous dermatitis. Complaints associated with these pathologies subside when the legs are elevated.

In case of doubt, further measures are required to distinguish VSU from ulcers resulting from arterial disorders and vasculitis [8]:

• Duplex ultrasonography may be employed to assess blood flow and vascular anomalies [9], and this method has largely replaced invasive angiography and venography.
• Air plethysmography is a non-invasive technique that allows for an evaluation of venous reflux and calf muscle function [7].

It is important to note that malignancies may develop from chronic wounds like VSU [10]. In this context, biopsy specimens should be obtained for histopathological and immunohistochemical analyses.

The whirlpool treatment followed by vigorous rinsing was found to remove more than four times as many bacteria as the whirlpool treatment alone. [ncbi.nlm.nih.gov]

Treatment for Venous Stasis Ulcers Treatment of ulcers differs based on their underlying cause. An experienced vascular specialist can help with accurate diagnosis in order to implement the best treatment option. [sierravein.com]

Treatment of leg ulcers is expensive. Is costs an estimated 5000 GBP per patient for three months of conventional treatment. [oceansidehyperbaric.ca]

METHODS: A retrospective review of patients with active VSUs (clinical, etiology, anatomy, and pathophysiology [CEAP] classification C6) that received EVLA of the GSV or combined EVLA of the GSV and IPV between May 2005 and May 2010 was completed. [ncbi.nlm.nih.gov]

[…] is unknown, but spirochetes, fusiform bacilli, and other bacteria are often present in the developing lesion, and protein and vitamin deficiency with lowered resistance to infection may play a role in the etiology. venereal ulcer a nonspecific term referring [medical-dictionary.thefreedictionary.com]

etiology + surgical options: chronic venous insufficiency: emedicine vascular surgery stasis dermatitis: emedicine dermatology venous ulcers are treated with compression of the leg to minimize edema or swelling. compression treatments include wearing [allnurses.com]

The exact etiology of venous stasis disease is not certain, but is thought to arise when venous valves that exist to prevent backflow of blood do not function properly. [utsurgery.com]

Definition / general Due to chronic venous stasis, usually on lower extremities May have secondary infection and ulcers Epidemiology Common disorder of middle-aged and older individuals Clinical features In the early stages, there is edema of the lower [pathologyoutlines.com]

Epidemiology The prevalence in the UK is 1-3 per 1,000. It increases with age and reaches 20 per 1,000 in the 80-plus age group. [patient.info]

Epidemiology The point prevalence of venous stasis ulceration western nations is estimated to be from 0.02 to 1 percent.1 Risk factors include age, obesity, history of leg injury and history of venous thromboembolism (VTE). [centerforvein.com]

Venous ulcer: epidemiology, physiopathology, diagnosis and treatment. Int J Dermatol. 2005;44(6):449–56. Alguire PC, Mathes BM. Medical management of lower extremity chronic venous disease. [woundcareadvisor.com]

METHODS: A retrospective review of patients with active VSUs (clinical, etiology, anatomy, and pathophysiology [CEAP] classification C6) that received EVLA of the GSV or combined EVLA of the GSV and IPV between May 2005 and May 2010 was completed. [ncbi.nlm.nih.gov]

Understanding the basic physiology of the venous system makes the pathophysiologic mechanisms clearer. [nursing.advanceweb.com]

"Thrombotic risk factors: basic pathophysiology". Crit Care Med. 38 (2 Suppl): S3–9. doi : 10.1097/CCM.0b013e3181c9cbd9. PMID 20083911. ^ Barbara G. Wells; Joseph T. DiPiro; Terry L. Schwinghammer; Gary R. Matzke; Gary C. Yee; Robert L. Talbert; L. [en.wikipedia.org]

Venous Stasis Ulcer Pictures Picture 1 : Venous Stasis Ulcer Image source : veinsveinsveins.com Picture 2 : Venous Stasis Ulcer on back of Leg Image source : veinsveinsveins.com Pathophysiology of Venous Stasis Ulcer Venous stasis ulcer is idiopathic [howshealth.com]

B 32 Pathophysiology The pathophysiology of venous ulcers is not entirely clear. Venous incompetence and associated venous hypertension are thought to be the primary mechanisms for ulcer formation. [aafp.org]

The increase in pressure and buildup of fluid prevents nutrients and oxygen from getting to tissues. SYMPTOMS Venous stasis ulcers are often an early sign of venous insufficiency. [athensveins.com]

Preventing VSUs is the most important aspect of CVI management. [woundcareadvisor.com]

Venous blood flow depends on the activity of the surrounding musculature as well as cardiac function [1]:

• On the one hand, leg muscles literally pump venous blood up the lower limbs against gravity while venous valves impede the blood to sink back to lower body regions. In patients suffering from venous insufficiency, however, these valves don't close properly.
• On the other hand, cardiovascular disorders associated with functional impairment of the right heart and venous congestion may hinder the undisturbed return of venous blood to the heart. Such pathologies may thus impose disproportionate burdens on venous valves and walls.

Both venous insufficiency and cardiovascular disease - often occurring concomitantly - may thus result in venous hypertension and blood stasis. Moreover, venous stasis may be related to a mechanical obstruction of veins, as is the case in patients suffering from vein thrombosis. Less common causes of venous stasis include phlebitis, malignancy [2], post-traumatic formation of an arteriovenous fistula [3], and congenital malformations [4], among others.

Venous stasis may affect superficial veins, a common condition known as varicose veins, or deep veins. In any case, chronic venous stasis leads to structural changes in venous walls and surrounding tissues. It has been suggested that fibrin leakage may result in the development of perivascular fibrinogen cuffs that hinder the passage of oxygen, nutrients and a variety of other molecules to dependent tissues. In the case of a traumatic lesion, this condition would largely impair wound healing and predispose for the onset of venous stasis ulcer (VSU). Of note, other hypotheses have been proposed regarding the pathogenesis of VSU [5].

1. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130(4):333-346.
2. Labropoulos N, Manalo D, Patel NP, Tiongson J, Pryor L, Giannoukas AD. Uncommon leg ulcers in the lower extremity. J Vasc Surg. 2007;45(3):568-573.
3. Young CJ, Dardik A, Sumpio B, Indes J, Muhs B, Ochoa Chaar CI. Venous ulcer: late complication of a traumatic arteriovenous fistula. Ann Vasc Surg. 2015;29(4):836.e831-833.
4. Phair J, Trestman E, Stableford J. Venous status ulcers due to congenital agenesis of the inferior vena cava in a 16-year-old male. Vascular. 2016;24(1):106-108.
5. Pocock ES, Alsaigh T, Mazor R, Schmid-Schonbein GW. Cellular and molecular basis of Venous insufficiency. Vasc Cell. 2014;6(1):24.
6. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: diagnosis and management. Am Fam Physician. 2013;88(2):102-110.
7. Alavi A, Sibbald RG, Phillips TJ, et al. What's new: Management of venous leg ulcers: Approach to venous leg ulcers. J Am Acad Dermatol. 2016;74(4):627-640; quiz 641-622.
8. Pannier F, Rabe E. Differential diagnosis of leg ulcers. Phlebology. 2013;28 Suppl 1:55-60.
9. Gornik HL, Sharma AM. Duplex ultrasound in the diagnosis of lower-extremity deep venous thrombosis. Circulation. 2014;129(8):917-921.
10. Eliassen A, Vandy F, McHugh J, Henke PK. Marjolin's ulcer in a patient with chronic venous stasis. Ann Vasc Surg. 2013;27(8):1182.e1185-1188.