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Management of Venous Insufficiency

Venous insufficiency is caused by veins in the legs that do not work right. This means that fluid can build up in your lower legs. It makes your legs swell. It can stretch the skin like an oversized balloon. The skin can break open and a wound can form. Your skin color can darken. Your skin may feel different.

Venous disease is a problem in the veins of the body. Problems with veins may cause:

  • Varicose veins
  • Thrombophlebitis
  • Deep Venous Thrombosis (DVT or blood clot) and
  • Venous leg ulcers
  • Swollen legs and feet
  • Dry, itchy skin
  • Brown color of the skin
  • Leg pain when legs are down
  • Pain that may go away when walking

Venous Leg Ulcers

Venous leg ulcers can happen between the ankle and the calf. They happen due to long-lasting disease in the veins and can be hard to heal. People with venous leg ulcers are at risk for getting infection and these wounds can keep you from moving around. Some of these wounds get started by trauma, like bumping your leg. When you have damaged veins, this can keep the wound from healing.

Causes of damaged veins:

  • Injury to the veins from trauma, blood clots or broken bones
  • Being overweight
  • Heredity
  • Pregnancy
  • Standing for too long
  • Surgery
  • Lack of movement or exercise

Let your doctor know about:

  • Pain
  • Swelling
  • Change in how your legs look

Call your doctor right away if any of these things happen:

  • Burning or aching pain that gets worse
  • Sudden increase in amount of swelling
  • Change in the usual color of your legs

How are venous leg ulcers treated?

  • The treatment of venous leg ulcers is to keep your legs from swelling. Your doctor can help to find the cause of your swelling by ordering special tests. The most common way to treat venous insufficiency and ulcers is with compression. This removes the excess fluid or swelling. Surgery may be an option for some people. Your doctor will help you to decide what is best for you. Even if you have surgery, you may still need to wear compression to keep your legs from swelling.
  • Elevate your legs above your heart as much as possible
  • Exercise daily

Surgical options for treating venous leg ulcers

  • Surgery to remove damaged veins
  • Vein ligation or vein stripping
  • SEPS procedure (sub endoscopic perforator surgery)
  • Skin grafts

Compression is the Key

  • Compression therapy is done using wraps, pumps or special stockings
  • You should follow your doctor's directions for how to use these
  • While you have a wound, you may have to wear compression for 24 hours a day
  • You will probably need to wear compression garments even after you heal

Special dressings, medications, and wraps might be used to help your wound heal faster. Sometimes skin grafts using your own skin or bio-engineered tissue are used to help your wound heal faster. Your doctor will help you to decide what is best for you

Life style changes are also very important.

Changes may include:

  • Weight loss
  • Exercise-especially walking
  • Good nutrition
  • Smoking cessation

By making these changes, you will heal faster and help keep your wound from coming back. We want to be a part of your wound healing team, but we can't do it without your help.

Wound, Ostomy, and Continence Nurses Soceity. (2005). Guidelines for management of wounds in patients with lower-extemity venous disease. Glenview, IL. WOCN