Venous Leg Ulcer (VLU)

Understanding Venous Leg Ulcer (VLU)

A Venous Leg Ulcer (VLU) is a shallow wound, often recurring condition located near the ankle of an individual. The fluid or blood moving out of the leg veins due to weakened valves becomes congestive, and causes pressure to build up in the veins. This pressure in turn causes the skin to breakdown, leading to the development of a VLU.

VLU's are among the most common causes of chronic wounds and occur in anywhere up to 2 million people in the United States.

Causes of Venous Leg Ulcer

The main cause of VLU is long-term (chronic) venous insufficiency, which is the inability of the leg veins to return adequate amounts of blood to the heart. This can arise from previous deep vein thrombosis (blood clot in a deep vein), hereditary weakness of the vein walls, or simply from aging.

Risk Factors Associated with VLU

Some factors that may increase the risk of developing a VLU include:

  • Advanced age
  • Female gender
  • Obesity
  • Immobility
  • History of varicose veins
  • Prolonged standing or sitting
  • Past deep vein thrombosis or pulmonary embolism
  • Smoking
  • Family history of venous insufficiency

Signs and Symptoms of Venous Leg Ulcer

The signs and symptoms of a VLU typically include:

  • Itching and swelling in the affected area
  • Pain near the affected area
  • Thickening and hardening of the skin around the ulcer
  • Development of a “lipodermatosclerosis” (thickening and hardening) of the skin above the ankle
  • Discoloration of the skin around the affected area
  • A foul odor from the wound

Diagnosis of Venous Leg Ulcer

VLU should be evaluated by a physician as soon as possible. Based on the physical examination, the doctor may order additional tests to diagnose the VLU. These tests may include a duplex ultrasound, a venogram, or magnetic resonance angiography (MRA). Imaging tests can reveal blockages and other abnormalities in the leg veins.

Treatment of Venous Leg Ulcer

The mainstays of treatment for venous leg ulcers are anticoagulation therapy, compression therapy, and wound care. Anticoagulation therapy helps prevent the formation of new clots and maintains the integrity of existing vessels. Compression therapy helps reduce the pain and swelling associated with venous leg ulcers by increasing circulation to the area. Wound care is important for cleaning and dressing the wound to promote healing and prevent infection.

Other treatments may include use of vascular Doppler imaging, sclerotherapy, or ligation. Each case is assessed on an individual basis and treatment depends on the severity of the condition, patient preference, and other health factors. Surgery may be recommended in cases where varicose veins are obstructing blood flow.