Venous ulcer

Venous ulcer is an occlusion in the vein or wound due to high blood pressure on the ankle inner region due to serious leaks. In this area, before the venous ulcer develops, skin nutrition due to leaking proteins due to the effect of high pressure is gradually deteriorating.

Venous ulcer development stages;

1. Erythema due to capillary dilation
2. Protein-rich fluid escape
3. Erythrocyte escaping from the vein
4. Demolition of hemoglobin
5. Accumulation of hemosiderin
6. Formation of brown red color
7. In the beginning, there is darkening in color and thickening of the skin.
8. Gode-free edema
9. Subcutaneous fibrosis
10. Skin hard and inflammation: Lipodermosclerosis

If this high pressure is not prevented in the following process, an ulcer develops.

Figure 1. Venous ulcer

Detailed venous Doppler ultrasound should be performed before starting treatment in patients presenting with venous ulcers. The pathology causing should be revealed. Often the cause is deep vein occlusion and insufficiency.

If leakage is detected in the veins in Doppler examination, treatment should be applied accordingly.
If this leak is caused by leakage in deep veins that were previously blocked and opened, it is not possible to treat these leaks. However, if there are leaks in superficial veins, these should be eliminated.
Treatment of venous ulcer differs considerably in terms of normal wound. In these, an elastic bandage or varicose socks should be worn to protect the wound area from the effect of this pressure due to its development due to the effect of high pressure.

• The wound is first dried after washing with saline.
• As much as possible, no watering antibiotic creams or solutions are applied. A very small amount of zinc idol can be applied.
• After putting gauze on the wound, the leg is wrapped in several layers with a cotton roll. Then, the bandage is wrapped on cotton for fixation.
• • After that, the most vital elastic bandage is wrapped or dressed in varicose socks. In this application, it is more difficult to dress the varicose socks and bandage application will be more useful.
• These bandages are repeated approximately 5 days after wrapping. With these treatments, in approximately 3-6 months, 70% of patients heal ulcers. Healing ulcers recur if not cared for.

If there is a leak due to superficial vein leakage and treatment, the ulcer does not recur. However, an ulcer caused by deep vein occlusion recurred if varicose stockings or elastic bandages are not used.

Necessary changes in lifestyle in venous ulcer

• If the patient is working in a job that requires standing for a long time, a job change should be made.
• Patient should not stand for a long time during the day.
• Patient should be on the move as much as possible.
• If patient smokes, he/she must cut it.
• Patient should rest 3-4 times a day for 15 minutes by lifting the leg up. Overweight should be avoided.

ANTALYA VARICOSE VEINS/Dr.İlhan Gölbaşı