Overview
The Venous Pattern and Tissue Injury
A venous leg ulcer is the visible result of long standing venous hypertension.
A venous leg ulcer is the visible result of long-standing venous hypertension. When leg-vein valves do not close effectively, blood refluxes and remains under excessive pressure in the lower limb. Fluid moves into the tissues, causing oedema; oxygen delivery becomes less effective; and the skin eventually loses its capacity to withstand minor trauma. The calf muscle pump normally helps return blood to the heart during walking. In venous disease, that pump is working against leaky valves. Compression supports the veins and limits oedema, while calf movement helps propel blood upward. The treatment is therefore aimed at the circulation problem beneath the wound, not simply at covering an open area of skin. Venous ulcers commonly occur in the lower leg, often around the gaiter area near the ankle. They may be shallow, irregularly shaped, moist, and associated with moderate or heavy exudate. Surrounding findings can include oedema, brownish skin staining from chronic venous disease, scaling, and fragile skin. A wound’s appearance suggests a cause but does not prove it. An arterial ulcer is more likely to be painful, pale, cool, dry,...
