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A venous ulcer tends to occur on the medial side of the leg, typically around the medial malleolus in the 'gaiter area' whereas arterial ulcer tends to occur on lateral side of the leg and over bony prominences. A venous ulcer is typically shallow with irregular sloping edges whereas an arterial ulcer can be deep and has a 'punched out' appearance.
The treatments to prevent the formation of blood clots are balanced against the risk of bleeding. [5] One of the goals of blood clot prevention is to limit venous stasis as this is a significant risk factor for forming blood clots in the deep veins of the legs. [6] Venous stasis can occur during the long periods of not moving.
This valvular incompetence combined with persistent venous obstruction from thrombus increases the pressure in veins and capillaries. Venous hypertension induces a rupture of small superficial veins, subcutaneous hemorrhage [7] and an increase of tissue permeability. That is manifested by pain, swelling, discoloration, and even ulceration.
Venous ulcers are common and very difficult to treat. Chronic venous ulcers are painful and debilitating. Even with treatment, recurrences are common if venous hypertension persists. Nearly 60% develop phlebitis which often progresses to deep vein thrombosis in more than 50% of patients. The venous insufficiency can also lead to severe hemorrhage.
Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.
Venous ulcers, which usually occur in the legs, account for about 70% to 90% of chronic wounds [2] and mostly affect the elderly. They are thought to be due to venous hypertension caused by improper function of valves that exist in the veins to prevent blood from flowing backward.
Recommendations by clinicians to reduce venous stasis and DVT/PE often encourage increasing walking, calf exercises, and intermittent pneumatic compression when possible. [5] [6] [7] Weakened Venous valves: these are crucial towards ensuring upward flow to the heart from the lower extremities.
An Unna’s boot [1] (also Unna boot) is a special gauze (usually 4 inches wide and 10 yards long) bandage, which can be used for the treatment of venous stasis ulcers and other venous insufficiencies of the leg. It can also be used as a supportive bandage for sprains and strains of the foot, ankle and lower leg.