Managing Venous Leg Ulcers, Superficial Varicose Veins, and Their Relationship: A Guide for Patients

 

Introduction:

Venous leg ulcers, superficial varicose veins, and their relationship can be complex and challenging. This information sheet is designed to help you understand these conditions, their connection to superficial varicose veins, and the various treatment options, including venous ablation, laser therapy/radiofrequency ablation, and sclerotherapy.

 

Understanding Venous Leg Ulcers and Superficial Varicose Veins:

Venous leg ulcers result from poor venous circulation due to damaged veins, leading to open sores on the lower leg. Superficial varicose veins are swollen, twisted veins near the surface of the skin, often caused by weakened valves in the veins.

 

The Relationship Between Refluxing Varicose Veins and Venous Leg Ulcers:

Refluxing varicose veins occur when the valves within the veins of the legs malfunction, leading to blood flow in the wrong direction. This refluxing blood can cause increased pressure within the veins, leading to chronic venous hypertension. Chronic venous hypertension can damage the skin and surrounding tissue, ultimately resulting in the development of venous leg ulcers. Occasionally, obstructed veins from deep vein thrombosis (DVT) can also lead to venous hypertension and venous leg ulcers, even through the superficial veins are normal.

 

Symptoms of Venous Leg Ulcers:

• Pain or aching in the affected leg.

• Swollen and heavy-feeling legs.

• Discoloured or reddish-brown skin around the ulcer.

• Itchy or dry skin.

• Open sore with uneven edges.

• Drainage of fluid or pus from the ulcer.

 

 

 

Symptoms of Superficial Varicose Veins:

Visible, bulging veins near the surface of the skin, often blue or purple in colour.

Aching or discomfort in the legs, especially after standing for long periods.

Itchy or burning sensations around the affected veins.

 

Managing Venous Leg Ulcers:

1. Seek Professional Help:

• Consult a healthcare professional immediately if you suspect you have a venous leg ulcer.

• They will perform an assessment and may recommend tests like ultrasound to determine the extent of the issue.

 

2. Compression Therapy:

• Compression bandages or stockings are often prescribed to improve blood circulation in the legs.

• Wear them as instructed by your healthcare provider to reduce swelling and promote healing.

• Dr Vun will confirm the health of your arterial circulation in the legs, to ensure compression therapy is safe.

 

3. Keep the Wound Clean:

• Gently clean the wound daily with mild soap and lukewarm water.

• Avoid harsh chemicals or scrubbing, as this can further damage the skin.

• Nursing staff may do this for you.

 

4. Dressing Changes:

• Your healthcare provider will recommend appropriate wound dressings.

• Change dressings regularly as advised to maintain a clean environment for healing.

 

5. Elevation:

•  Elevate your legs above heart level for about 15-30 minutes several times a day to reduce swelling.

 

6. Healthy Lifestyle:

• Maintain a balanced diet rich in nutrients to support healing.

• Exercise regularly to improve circulation.

• Don't smoke, as smoking hinders the healing process.

 

Advanced Treatment Options for Superficial Varicose Veins:

• If you have superficial varicose veins, your healthcare provider may recommend treatments like sclerotherapy or minimally invasive procedures to close off or remove these veins.

• Minimally invasive procedures like laser therapy/radiofrequency ablation, or surgery may also be used to treat problematic veins, and offer a more permanent solution for venous leg ulcers. There is good evidence that this therapy improves healing rate and prevents recurrence.

• Sclerotherapy involves injecting a solution into the varicose vein, causing it to collapse and fade away.

 

Remember:

• Healing times vary from person to person, and it may take several weeks or months.

• It's crucial to follow your healthcare provider's instructions closely for the best outcome.

• Don't hesitate to ask questions and seek support from your healthcare team or support groups.

 

Conclusion:

Venous leg ulcers and superficial varicose veins can be managed effectively with various treatment options, including advanced procedures like venous ablation, laser therapy, radiofrequency ablation, and sclerotherapy. By addressing both the ulcers and the underlying venous issues, you can promote healing and improve your overall well-being. 

 

Please speak with Dr Simon Vun, FRACS if you have further questions about varicose veins, venous leg ulcers or circulation problems.