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171 Town Center Drive, Anniston, Alabama 36205 • Lewis E. Sellers MD
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The development of a venous ulcer or leg wound is a costly and painful late complication of vein disease. Venous ulcers lead to disability including lost days of work and the expense of wound care. Ulcers are a result of deep vein disease which causes venous blood to reflux or pool in the legs.
Venous reflux creates a pooling of protein rich fluid in the skin and subcutaneous tissue of the legs. This creates an environment of diminished nutrition and an accumulation of waste products. When the problem is left untreated, it leads to skin changes and ulcers, which are avoidable with early intervention. Tissue changes may first be noticed as dark red, purple, or brown skin discoloration of the lower legs (often looks like bruising). The skin may even take on a leathery feel or appearance. If you have leathery skin, or red, purplish, or brown skin discoloration, visible spider or varicose veins, or other skin changes, Dr. Sellers recommends seeking care early to avoid painful and costly venous ulcers.
At the ulcer stage, you may experience painful and swollen legs. With good wound care and the use of compression, most ulcers will heal. However, without compression and good skin care, within a year more than half of patients will have recurrence of their ulcer. With compression, good skin care and medical intervention to correct the venous reflux, the incidence of recurrence is less than 20% in a year.
Venous ulcers develop as reflux allows venous blood to pool in your leg. This reflux may be the result of saphenous vein, perforator vein, or non-saphenous vein reflux. As fluid leaks out of the dilated veins into the surrounding tissues, swelling interferes with the movement of oxygen and nutrients into these tissues and the removal of waste products, resulting in inflammation, tissue damage, and venous ulcer formation.
The key to successful treatment of venous ulcers is a detailed duplex ultrasound mapping study. Once a map is created, Dr. Sellers uses the most effective methods to treat the underlying venous reflux including Endovenous Therapy, Ambulatory Phlebectomy, ligation of perforator veins, and Sclerotherapy.
The principle of the treatment of venous ulcers starts with correction of saphenous vein reflux first if present. In some cases, the only finding may be deep vein reflux or damage to the deep veins from deep vein thrombosis. In this case the treatment of choice is Wound Care to heal the ulcer and compression for the deep vein disease.
Sample Daily Self-Care Plan for Venous Ulcers
If the ulcer does not heal with good wound care, additional duplex testing is needed to evaluate for any persistent reflux. If persistent perforator vein reflux or additional refluxing varicose veins are noted, they are appropriately treated.
Many patients report that their ulcers heal quickly after medical correction of the underlying venous reflux.
Visit our Make an Appointment Page to schedule a consultation with Dr. Sellers in Anniston, Alabama at McClellan Park Medical Mall.
Appearance of Bruising: red, purple, and brown discoloring of skin which can lead to an ulcer.