Venous leg ulcers are the most severe consequence of untreated venous reflux, but fortunately, they are often preventable and treatable.
Venous Ulcers Explained
It is estimated that 1% of the general population and 5% of patients with varicose veins will develop a chronic venous ulcer during their life. Once established, they can lead to a significant decrease in quality of life and patients may experience social and economic decline.
It is unfortunate that medical misunderstanding and failure to be proactive in preventing and treating the complications of venous reflux is largely to blame for these shocking statistics.
Like all things health related, prevention and early action is key.
Skin changes, such as the development of red, brown or “rust like” patches (hemosiderin staining, or venous eczema), are an early warning sign that an ulceration may occur. Eventually, white patches (atrophe blanche) may form, heralding the breakdown of the skin and leading to ulcer development.
If you or a loved one has any of the above warning signs, a specialist opinion and ultrasound assessment is recommended.
If there is reflux predominately affecting the superficial system, the chances of cure with endovenous treatments is high. If reflux is mainly affecting the deep system, a cure is unlikely and management involves wound dressings and compression garments.
If the patient is unable to walk or has poor ankle movement, interventions are less successful.
Above: Venous ulcers now healed (pigmentation persists) following ablation of great saphenous and 2mm incompetent perforator vein adjacent to ulceration.
Key Messages about Venous Ulcers
Prevention is better than cure!
Treat symptomatic varicose veins before complications arise
Be on the lookout for skin changes (i.e itchiness, redness, discolouration and blanching)
Seek specialist evaluation BEFORE an ulcer develops
If an ulcer does develop seek prompt specialist evaluation