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Definition

Venous stasis is a pooling of blood in the veins. A venous stasis ulcer is a wound on the skin caused by the pooled blood. These ulcers occur most often on the legs.

Causes

Veins have a series of valves that help the blood move in the right direction. When these valves fail to work properly, blood can move backward and pool in the veins. The pooled blood pushes fluid and blood cells out of the veins and into nearby tissue. The leaked fluids irritate the tissue and cause inflammation. Over time, the inflammation can breakdown tissue and lead to ulcers.

Risk Factors

Factors that may increase your risk of venous stasis include:

Smoking is harmful to blood vessels. It may play a role in venous stasis.

Varicose Veins

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Symptoms

An ulcer is present for more than 4 weeks. Venous stasis ulcers may:

  • Be painful and itchy
  • Be discolored, darkened, and scaly skin around the edges
  • Have foul-smelling discharge from the wound if an infection is present

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. The diagnosis can often be made based on this information.

An ultrasound may be done. It can help to see how deep the wound is. It can also show blood flow to the area.

Treatment

The ulcer will need some time to heal. It usually takes 4 weeks or more. Special dressings are usually needed. They can protect from infection and speed healing.

Excess fluid can cause irritation and further damage. The excess fluid will need to be moved away from the area. Options include:

  • Compression stockings
  • Elevate the affected limb above the heart when sitting
  • Exercises—muscles help to pump fluid out of the area

Medicine may also help to improve blood flow. The medicine may be a pill or applied right to the skin. Options may include:

  • Statins
  • Aspirin
  • Pentoxifylline—reduces the thickness of the blood

Other medicine may be applied to the skin to help healing.

Surgery may be needed for larger wounds to:

  • Remove dead or infected tissue
  • Place healthy skin over the wound to help healing

Prevention

Venous stasis ulcers often happen again. Managing venous stasis will help prevent future ulcers. Factors that may help include:

  • Use of compression stockings
  • Weight reduction in people with obesity
  • Treating any cause of the venous stasis

RESOURCES

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

Society for Vascular Surgery  https://vascular.org 

CANADIAN RESOURCES

Canadian Vascular Access Association  http://cvaa.info 

Health Canada  http://www.canada.ca 

References

Collins L, Seraj S. Diagnosis and treatment of venous ulcers. Am Fam Physician. 2010;81(8):989-996.

Venous insufficiency and ulcers. New York-Presbyterian website. Available at: http://www.nyp.org/vascular/services/venous-insufficiency-and-ulcers. Accessed August 17, 2017.

Venous leg ulcer. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Leg-ulcer-venous/Pages/Introduction.aspx. Updated February 2, 2016. Accessed August 17, 2017.

Venous leg ulcers. Patient website. Available at: https://patient.info/health/venous-leg-ulcers-leaflet. Updated August 1, 2016. Accessed August 17, 2017.

Venous ulcer. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115837/Venous-ulcer  . Updated September 18, 2016. Accessed August 17, 2017.

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