Leg Wound Not Healing? It Could Be A Venous Ulcer Caused By Varicose Veins — A Serious Issue

The longer venous ulcers go untreated, the greater is the risk of developing dangerous complications such as gangrene.

Varicose veins occur when vein valves malfunction.

Source : Canva (modified)

By Dr. Saurabh Joshi

Deepak (78, name changed) had been suffering from varicose veins in his left leg (swollen due to accumulation of blood) for 20 years. He was undergoing compression therapy (pressure applied to improve blood flow) but his condition progressed to a non-healing wound or a venous ulcer. The swelling in his leg increased considerably, the skin darkened, and he was in constant pain. The condition became so severe that one of his toes had to be amputated. 

Since conventional therapies had not worked, Deepak required specialised treatment. As he had undergone heart surgery and was on blood thinners, surgery was deemed too risky. Doctors performed a minimally invasive procedure and Deepak left the hospital the same day. 

Deepak’s story illustrates how varicose veins, which may initially seem harmless, can lead to the development of venous ulcers. If not treated promptly, these ulcers can cause infections that can spread to other organs. 

Varicose Veins And Venous Ulcers — The Link

Varicose veins occur when vein valves malfunction. Arteries carry blood from the heart to the body, while veins return it. In the legs, veins work against gravity to pump blood back, relying on valves to prevent backward flow. Weak or damaged valves, as in varicose veins, allow blood to flow backward and pool, causing veins to bulge or twist.

Varicose veins are often seen as a cosmetic issue that does not need treatment. However, they may lead to major complications such as venous leg ulcers. These are wounds that may take several weeks or months to heal, and in some cases, may never heal. They resemble shallow sores surrounded by discoloured skin. The symptoms include swelling, itching, dull ache, a foul odour, and discharge of pus or other fluids.

Other than varicose veins, risk factors include smoking, a sedentary lifestyle, injuries, older age, family history, and surgeries. The longer these ulcers go untreated, the greater the risk of developing dangerous complications such as gangrene (loss of blood supply that causes tissues to die). 

Venous leg ulcers can negatively impact patients’ quality of life. Many cannot carry out their daily activities due to the pain, and experience a loss of self-esteem, depression, and social isolation. Furthermore, they may feel shame due to the appearance of these ulcers.

Varicose Veins Diagnosis And Treatment

The diagnosis of venous leg ulcers begins with a physical examination, often followed by a colour-flow duplex ultrasound to assess blood flow and vessel structure. Additional tests, such as the ankle-brachial index and imaging (MRIs, CT scans), may also be used. Treatment focuses on improving blood circulation, starting with compression therapy, antibiotics, daily wound cleaning, and special dressings. The doctor may also conduct a procedure called debridement or removal of dead tissue and other debris. Advanced treatments, including surgery, may also be needed. 

However, surgery may not be the right option for several patients who suffer from conditions such as diabetes or heart disease. In this complex population, an advanced and minimally invasive procedure using adhesive glue therapy can be used. This involves injecting medical glue into the damaged veins to seal them, redirecting blood flow to healthier veins. Adhesive therapy offers several benefits, including quicker recovery times, lesser pain, and decreased risk of complications.

Some ways of decreasing the risk of venous ulcers include losing weight or maintaining it at an ideal level, getting adequate exercise, moving around often, and avoiding smoking. If you're living with varicose veins, it's essential to seek professional help and promptly visit the nearest vein clinic for timely treatment and expert care. 

Varicose veins are not a cosmetic issue brought on by ageing. Without treatment, it can result in painful venous ulcers and infections that may require amputations. Early diagnosis and treatment are essential to help patients heal faster. Innovations such as adhesive glue therapy have provided patients with more options for effective and minimally invasive treatment methods. By addressing these issues now, individuals can be free and enjoy life one confident step at a time.

Dr. Saurabh Joshi is Vascular Interventional Radiologist, Vein Center, Mumbai.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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