19, 9, 2022

What you need to know about: Non-Healing Ulcers & Wounds

2022-08-18T15:55:24-07:00

Non-Healing Ulcers &  Wounds

We might all be familiar with ulcers in a general manner, but certain types of ulcers behave quite differently due to various contributing factors. These are non healing ulcers or non healing wounds, and if not treated with care and in good time, such wounds can pose a serious risk to the patient’s health. Severe cases may lead to amputation of the affected limbs or loss of life in the most extreme circumstances. The nonhealing ulcers cases we treat here at La Jolla Vein & Vascular fall under peripheral arterial disease (PAD) and a subcategory of arterial disease.

Non-healing wounds or ulcers do not follow the usual healing process and are referred to as chronic wounds should they persist beyond 3 weeks. Such wounds can be a heavy burden to live with for anyone. Still, the board-certified vascular surgeons and specialists at La Jolla Vein & Vascular are dedicated to administering effective treatment and management solutions to all patients so they may resume a healthy, productive, and pain-free life.

Types of Non-Healing Ulcers

In general, patients will present with one of three categories of non-healing ulcers, with these categories being broadly defined by the major causative factors allowing for their development. These are:

Arterial or Venous Ulcers

These are found to account for between 70% up to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of a failure of the valves in a person’s blood vessels of both arteries and veins. These valves are responsible for preventing the backflow of blood as it passes within them. The consequent outcome is a lack of nutrient and oxygen-rich blood from reaching the affected tissues and sets up the conditions favoring non-healing wounds.

Pressure Ulcers

These are ulcers that are brought about by the restriction of blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is mostly encountered among patients with full or partial paralysis and those who are bedridden for extended periods.

Diabetic Ulcers

These are also highly prevalent chronic wounds, and are on the increase among patients owing to the ever-increasing cases of diabetes among the population. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to have to undergo limb amputation as a complication of the condition.

The high amputation rate among diabetics is attributable, in part, to the neuropathic effects of the ailment. Neuropathy leads to a lack of pain perception in the affected individual, meaning that they may be entirely unaware of minor wounds on their feet and legs in good time, allowing for their infection or repeat injury. It is also made more likely by the immunosuppressive effects of the condition, which makes the patient more vulnerable to infection.

“Bringing Experts Together for Unparalleled Vein and Vascular Care”

La Jolla Vein & Vascular (formerly La Jolla Vein Care) is committed to bringing experts together for unparalleled vein and vascular care. 

Nisha Bunke, MD, Sarah Lucas, MD, and Elliot DeYoung, MD are specialists who combine their experience and expertise to offer world-class vascular care. 

Our accredited center is also a nationally known teaching site and center of excellence. 

For more information and to book a consultation, please give our office a call at 858-550-0330. 

For more information please check out our Youtube Channel at this link.

For more information on varicose veins and eliminating underlying venous insufficiency, check this link out full of resources. 

What you need to know about: Non-Healing Ulcers & Wounds2022-08-18T15:55:24-07:00

10, 3, 2022

Understanding Venous Insufficiency

2022-12-13T14:11:01-08:00

When you become a patient with La Jolla Vein Care, you will go through a screening process, and a vascular evaluation using ultrasound technology to diagnose your venous reflux disease. Chronic venous insufficiency is a disease affecting at least 50 million Americans. It is very common, but unfortunately undiagnosed. Through our venous insufficiency Duplex Ultrasound test, our vein specialists can determine exactly what is going on in the patient’s veins. 

The anatomy and process of venous insufficiency or venous reflux disease: 

One of the major veins that takes the blood to the heart is deep inside the muscles of the thigh and calf called the deep veins. Parallel to this lies the superficial veins inside the legs. Superficial veins dump the blood into the deep vein in the groin area and collectively they take the blood back to the heart. 

The direction of the blood flow begins from the ground up towards the heart. Both deep and superficial have a structure system known as the valves. They function as a safety unit directional valve system. Where the blood can flow upward and not downward and be open or closed off. Similarly the same type of structure is found in your heart with heart valves. 

Over the course of the years, depending on your occupation, family history, pregnancy, surgeries, any trauma or injury to your legs, and any kind of underlying muscular or skeletal problem will contribute to problems with the valves in your legs. The valves, over the course of the years may get farther apart from one another. They will still be able to open and close, but the main problem will be the blood flow will not be able to go in one direction. This causes the veins to become enlarged. As a result,  the valves remain open and the blood to flow upward and also downward. This is known as venous reflux disease or venous insufficiency. 

venous reflux disease

A consultation with one of our vein specialists for chronic venous insufficiency involves taking a detailed history and physical examination in combination with a venous reflux ultrasound study.  Based on your personal findings, a customized treatment plan will be discussed which may include doing nothing, conservative management, or various treatment options based on your individual needs. 

For any more questions about venous disease and the process of diagnosis and treatment, please call us at (858)-550-0330.

Understanding Venous Insufficiency2022-12-13T14:11:01-08:00

20, 1, 2015

3, 4, 2014

Meet Dr.Bunke, La Jolla Vein Care Specialist

2014-04-03T00:35:56-07:00

Dr. Nisha Bunke

Dr. Nisha Bunke

Dr. Nisha Bunke

Dr. Nisha Bunke Paquette, MD, FACPh is one of La Jolla Vein Care’s highly trained board-certified venous disease specialist.  Dr. Bunke specializes in highly advanced and minimally invasive outpatient procedures for treating a wide spectrum of venous conditions. Dr. Bunke  is one of a few southern California physicians board-certified and fellowship trained in Venous and Lymphatic Medicine. She was the first physician in the United States to complete fellowship training supported by the American College of Phebology and was mentored by world renowned vascular surgeon, Dr. John Bergan. Presently, she sees patients at La Jolla Vein Care, San Diego County’s largest dedicated vein center.  She is also a Volunteer Clinical Instructor of Surgery at the University of California San Diego (UCSD) School of Medicine, member of the Scripps Ximed Medical Group and Veteran’s (VA) Medical Center. For five years, Dr. Bunke  has run the vein clinics at the VA Medical Center, providing vein care for our veterans. From 2010 until 2012, she also directed UCSD’s Vein Clinic.

Dr. Bunke is a physician and scientist, actively leading clinical research studies. In 2009, Dr. Bunke  was awarded the Internationale Union of Phlebologie Research Fellowship and the Best Young Presenter Award in Monaco. Collectively, Dr. Bunke  and Dr. Bergan were awarded the 2008 JOBST Research Award for the Advancement of Phlebology for their research on Inflammatory Bio-Markers of Venous Insufficiency. Moreover, Dr. Bunke-Paquette is a member of The Clinical and Translational Research Institute (CTRI) of the University of California San Diego (UCSD), the American Medical Association (AMA), San Diego County Medical Society, Society for Vascular Medicine, American College of Phlebology (ACP), American Venous Forum (AVF) and the Society for Vascular Ultrasound (SVU).  She has published chapters in several medical textbooks, academic journals and most recently co-edited the second edition of the Vein Book, along with John Bergan.

To make an appointment to see Dr. Bunke, call 858-550-0330. 065_NOR2320

 

Meet Dr.Bunke, La Jolla Vein Care Specialist2014-04-03T00:35:56-07:00

30, 10, 2012

San Diego’s Top Doctors

2012-10-30T12:55:37-07:00

La Jolla Vein Care Doctors in San Diego Magazine 2013 Top Doctors

La Jolla Vein Care Doctors in San Diego Magazine 2013 Top Doctors

Our two fantastic doctors, Dr. Nisha Bunke-Paquette and Dr. Helane Fronek were featured in San Diego Magazine’s Top Doctor Issue. They were interviewed about varicose veins, venous disease and treatment options.

San Diego’s Top Doctors2012-10-30T12:55:37-07:00
Go to Top