Ulcers are wounds or sores that will not heal or keep returning. They may or may not be painful. The leg is usually swollen and may burn or itch. There may also be a rash, redness, brown discoloration or dry, scaly skin.Venous ulcers are located below the knee and are primarily found on the inner part of the leg, just above the ankle.

The bottom of a venous ulcer is usually red. It may also be covered with yellow fibrous tissue or there may be a green or yellow discharge if the ulcer is infected. Fluid drainage can be significant with a venous stasis ulcer.

The borders of a venous ulcer are usually irregularly shaped and the surrounding skin is often discolored and swollen. It may even feel warm or hot. The skin may appear shiny and tight, depending on the amount of edema (swelling). The skin may also have brown or purple discoloration about the lower leg, known as “stasis skin changes.”

Venous stasis ulcers are common in patients who have a history of leg swelling, long standing varicose veins, or a history of blood clots in either the superficial or the deep veins of the legs. Ulcers may affect one or both legs.

Venous stasis ulcers affect as many as 2.5 million people in the US and are more common in women than men. A estimated 500,000 persons are diagnosed each year with venous stasis ulcers. There is a high rate of recurrence in noncompliant patients.

Risk Factors

  • Increased age
  • Chronic venous insufficiency
  • Post-thrombotic syndrome

Symptoms or Clinical manifestations

Preceding symptoms

  • Swelling and aching of the legs
  • Dependent edema
  • Varicose veins
  • Reddish-brown discoloration
  • Eczematous changes with redness, scaling, and pruritus

Ulceration

  • Lower leg and ankle, most often in the medial malleolus are; recurrence at the same location is common
  • Associated with weeping, oozing, and crusting
  • Typically range in size from 0.5 cm to 10 cm across

A 15 year study* was accomplished to document the results of patients who wore compression stockings during therapy for chronic venous ulcerations. The study objective was to document the healing percentage and long term recurrence rate of venous ulcers when applying compression therapy. In the study of 113 patients with severe chronic venous insufficiency, 93% (105 patients) achieved complete ulcer healing in a mean of 5.3 months. 96% of the patients wore 30-40mmHg knee-high or thigh-high stockings; 2% wore 40-50mmHg knee-high stockings and 2% wore 20-30mmHg knee-high stockings.

At the conclusion of the study, information was available on 73 of the 105 patients who experience ulcer hearing after wearing compression stockings. 58 of the 73 patients remained compliant with compression stockings and of these 58 patients, 22% had recurring venous ulceration within 36 months. The other 15 of the 73 patients, who were not compliant with wearing compression stockings, had a 100% recurring venous ulceration within 36 months.

*Mayberry JC, Moneta GL, et al. Fifteen-year results of ambulatory compression therapy for chronic venous ulcers. Surgery, 1991, 109:578-81