2. Venous Ulcers—Venous
Ulcers are the most common and costly chronic wound ulcer seen in the
United States and affect women three times more often than men. The
prevalence of lower limb ulcers ranges from 0.12% to 0.32% of the
general population. (Burrows 2006) Patients experiencing venous ulcers suffer from the inability to heal and the high rate of reoccurrence at 72%. (Sibbald 2006) Venous ulcers can cause pain, limit activities of daily living and negatively impact quality of life.
Venous ulcers can be caused by damaged or leaky
venous valves, or a faulty calf muscle pump action which causes to
sustained high venous pressure known as venous hypertension. These
ulcers are usually located around the medial malleolus and are
accompanied by edema or swelling of the affected leg, large amounts of
drainage, and often have a scaly type of skin condition known as
dermatosis. It is important to note that not all leg ulcers are venous
in origin particularly those ulcers located above or below the gaiter
and ankle region.
People with venous insufficiency sometimes report
having had a blood clot in the affected limb. Due to the interruption
of blood flow back to the heart, pooling of blood is seen in the limb
that sometimes results in swelling. Eventually, protein from blood
vessels can leak into the tissue and cause an ulcer to form. A
cornerstone of treatment for venous ulcers beyond local ulcer management
is the use of sustained compression in order to decrease the edema by
wrapping the legs to promote blood flow back to the heart.