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Venous Leg Ulcers

leg ulcer

What are Leg Ulcers?

A leg ulceration is the most severe form of chronic venous insufficiency.  This is referred to as a ‘venous leg ulcer.’  Venous leg ulcers make up 70% of all chronic leg wounds.  Therefore, a venous leg ulcer is much more common than a diabetic or arterial ulcer.  It is caused by long-standing pressure within the leg veins, resulting from 1) venous reflux through faulty valves, 2) a blockage within the deep veins or 3) from the inability to use the calf muscles or a combination.  Venous reflux is the most common cause of a venous leg ulcer.  The increased pressure within the leg veins (we call this venous hypertension) causes an inflammatory response. Inflammation then causes changes in the skin, usually around the ankles (this is where pressure is the greatest).  The inflammatory process will cause the skin around the ankles to become brown or discolored, and eventually, the skin will break open.  The leg wound can be healed by treating the underlying vein condition.  Venous leg ulcers can also be prevented by early intervention with non-invasive procedures.  If you have signs of chronic venous insufficiency (such as skin discoloration around the ankles) you should address your underlying vein condition to prevent the skin from breaking open.

Healing leg ulcers: understanding, treatment, and prevention strategies

Development of wounds around the ankles, called venous leg ulcers
leg and ankle ulcers
compression stockings help with venous disease, mediack assistant helping patient adjust her compression stockings

How we can help

Although treatment cannot reverse existing skin changes in CVI, it can forestall further degradation and ulceration. Addressing the underlying venous reflux diminishes inflammatory changes, potentially alleviating itchiness and dryness. Yet, persistent skin discoloration might endure despite successful reflux treatment. Central to treatment is rectifying the underlying venous reflux.

Managing Venous Leg Ulcers

Venous leg ulcers, a potential outcome of severe CVI, demand a comprehensive healing approach. Treatments may involve:

  • Rectifying the underlying venous reflux
  • Referral to a specialized wound care clinic
  • Implementing compression therapy

A comprehensive ultrasound examination determines the precise location of the underlying reflux, whether in the saphenous veins, perforator veins, tributaries, or deep veins, guiding the appropriate treatment trajectory.

Chronic Venous Insufficiency entails complex implications for those affected. Armed with understanding the condition, its symptoms, and available treatments, individuals can make informed health decisions, navigating the path to wellness.

Understanding & addressing non healing ulcers

Non-healing ulcers, a term you might have heard in passing, carry a significance that goes beyond the surface. Unlike typical wounds, these ulcers possess unique characteristics and challenges, often requiring specialized attention. At La Jolla Vein & Vascular, we recognize the gravity of non-healing ulcers and their potential impact on patients’ lives. Let's explore the intricacies of these ulcers, their causes, symptoms, and the comprehensive treatments we offer to ensure a healthier, pain-free existence.

Types of Non-Healing Ulcers: Understanding the Varieties

Non-healing ulcers fall into distinct categories, each stemming from different underlying factors. The three major classifications are:

  • Arterial or Venous Ulcers: These ulcers result from compromised blood flow, either due to arterial or venous issues. Inadequate circulation impairs the body’s natural healing processes, leading to chronic wounds.
  • Pressure Ulcers: Pressure ulcers, also known as bedsores, arise from prolonged pressure on the skin and underlying tissues. Patients with limited mobility are particularly susceptible.
  • Diabetic Ulcers: Individuals with diabetes are prone to foot ulcers due to nerve damage and circulation problems, making their wounds challenging to heal.

 

Causes of Non-Healing Ulcers: Delving into the Underlying Factors

The risk factors contributing to non-healing ulcers are diverse but share the ability to disrupt the body’s wound healing mechanisms. These factors include:

  • Nerve Damage (Neuropathy): Nerve impairment hampers the body’s ability to sense and respond to injuries, leading to chronic wounds.
  • Circulatory System Issues: Compromised blood flow starves tissues of oxygen and nutrients necessary for proper healing.
  • Underlying Health Conditions: Conditions like diabetes and vascular diseases can significantly impede the body’s natural healing processes.

Recognizing Symptoms: Taking Timely Action

Waiting for weeks before seeking professional assistance for a non-healing wound is risky, especially if you fall within the high-risk categories.

Be vigilant and watch out for the following warning signs:

  • Darkening or bluish discoloration around the wound edges
  • Persistent or worsening pain around the wound
  • Foul odor emanating from the wound
  • Swelling, redness, and spreading of inflammation
  • Continuous leaking or draining from the wound

These symptoms often indicate infection and the failure of the body’s natural healing mechanisms. Prompt intervention is essential to prevent further complications

Comprehensive Treatment Approaches: Tailored to Each Case.  Managing non-healing ulcers requires a personalized approach, considering the diverse causes and complexities.

Treatment options include:

  • Compression Wrapping: Enhancing blood flow to aid healing.
  • Specialized Dressings and Topical Medication: Promoting wound healing and infection prevention.
  • Patient Self-Care and Education: Empowering patients to actively participate in their healing process.
  • Negative Pressure Therapy (NPWT): Applying controlled vacuum pressure to stimulate healing.
  • Surgery: Removing damaged tissue to facilitate healing.
  • Growth Factor Therapy: Boosting the body’s natural healing mechanisms.
  • Debridement: Removing dead tissue to promote healthy tissue growth.
At La Jolla Vein & Vascular, we prioritize the comprehensive treatment of non-healing ulcers. Our board-certified vascular surgeons and specialists are committed to delivering effective solutions that enable patients to regain their health, productivity, and quality of life. By tailoring treatments to individual needs, we ensure that our patients receive the best care possible.

Remember, understanding non-healing ulcers and seeking timely treatment is key to preventing complications. Our team is here to guide you through every step of your journey towards healing and well-being.
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All the staff are awesome the doctor was great and nurse practitioner the nurses they were all great I really enjoyed my visit there they made me feel very comfortable they attended and explained everything to me anything I needed or needed to be done they were there I'd recommend this place to everyone great place and the people are wonderful thank you can't wait to see you in 6 weeks.
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The entire team is professional, attentive and kind. They all make you feel as comfortable as possible when going thru an unfamiliar procedure. Their knowledge is comforting. Dr. Steinberg is outstanding! She an expert in her craft and is thorough when designing a specific plan for each patientpays close to details of a patients plan. She is detailed oriented and will make adjustments to make sure she executes the most successfull solution. I love her positivity, energy and confidence. Entire team = PRICELESS
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This place is awesome. They really go into detail with you about your problem. I have problems with the veins in my legs & they seem to really take interest in helping to find a way to sovle my problem. This is my first time here but they are very professional & really seem to care about me personally. They tend to all your needs here. Very kind people & they treat you with the utmost regard.
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Dr. Amanda Steinberger is a Harvard-trained, board-certified vascular interventional radiologist. She specializes in a broad range of superficial vein disease including varicose veins, spider veins, venous leg ulcers, lymphedema and cosmetic laser vein treatments. Dr. Steinberger sees patients in our La Jolla Office.

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