Venous Ulcers Treatment

What are Venous Ulcers and what are their Treatment methods?
Venous ulcers are slow-healing wounds, the most common among other types of ulcers, occurring in up to 80% of all ulcers.

Venous ulcers appear below the knee, often appearing on the inside of the leg directly above the ankle, and are caused by insufficient functioning of vein valves, causing severe pain to the patient and exposing him to a lot of health problems.

Ulcers begin to appear by changing the skin color to red and then gradually brown, then small wounds appear as a result of the leg hitting any solid body or as a result of wearing rough socks or may start to appear on their own. These changes are signs of the onset of ulcers.

How does Venous Ulcers form?
Venous ulcers often occur as a result of venous insufficiency; This means that the veins do not function properly and are unable to perform their main function of taking blood from the limbs to the heart. When a problem occurs, the blood flows down instead of pushing it upwards, this leads to severe venous congestion as a result of the blood accumulation inside it and leads to constant hypertension within the veins.

Causes of Venous Ulcers:
• Deep vein thrombosis.
• Exposure to leg fractures, especially in the ankle.
• Peripheral arterial disease.
• Lack of movement and lack of activities such as walking and sports.
• Obesity where weight gain leads to high blood pressure and adversely affects the veins of the legs.
• Age.
• A complication of varicose veins in advanced cases that have not undergone appropriate treatment.
• Having diabetes where high blood glucose level affects the circulation in the legs.
• Chronic hypertension.
• Poor intravenous circulation due to kidney failure, liver or heart.
• Rheumatoid arthritis.

Symptoms of Venous Ulcers:
The patient who suffers from Venous ulcers has some problems that make him uncomfortable. It also hampers him from living normally, including:
• Skin color changed to brown.
• Swelling of the affected area.
• Feeling pain in the leg in the early stages and soon the pain gradually decreases.
• Stiffness of the skin around the affected area.
• Eczema and itching.
• Green or yellow discharge from ulcers if infected.

Do the patients suffering from varicose veins in legs necessarily have venous ulcers? What are the preventive methods of venous ulcers for patients with varicose veins in legs and impaired venous circulation?
Statistics show that varicose veins patients may not suffer from venous ulcers, but can avoid them by:
1. Undergoing the most appropriate treatment for varicose veins according to the condition and this is determined by Dr. Waleed El-Daly. He studies the patient's case and is informed with all the tests. Treatment, therefore, varies between laser therapy, injection or combination through the most recent technique globally, the typical CLaCS technique.
2. Focus on any changes in the colour of the leg skin when it appears, and quickly visit the doctor who is the best and able to deal with such conditions, namely Dr. Waleed El-Daly.
3. Wearing compression socks during the day to maintain blood pressure at normal rates, while ensuring that they are replaced in case of deterioration of their flexibility so as to maintain their maximum effectiveness.
4. Avoid standing or sitting for long periods continuously.
5. Lose excess weight.
6. Control of chronic diseases, such as diabetes and heart disease.
7. Quit smoking to improve the chances of recovery.

Treatment of Venous Ulcers:
Venous ulcers are a serious condition requiring early diagnosis to initiate a treatment plan and, in particular, are more serious in the event of bacterial rot. It is diagnosed with pulse examination in the feet, examination of veins and arteries, and comprehensive evaluation of ultrasound circulation.

Dr. Waleed El-Daly, Assistant Professor of Vascular surgery and Treatment of Diabetic Foot, treats Venous Ulcers, taking into account the treatment of the cause of their occurrence. For example, if the patient suffers from obesity, it is important to lose weight to avoid getting ulcers again.

The treatment period varies according to the size of the ulcer, and the small wounds usually heal within 3 months, through the following treatment plan:

- Treatment is done by ligaments and bandages to reduce blood pressure on veins.
- It is also recommended to lift the leg slightly upwards in case of sitting or lying down to reduce the pressure on the leg and make it at average level.
- If the ulcer is infected, Dr. Waleed El-Daly prescribes some oral antibiotics, such as penicillin for most cases. Those who are sensitive to penicillin can use alternative antibiotics such as erythromycin while avoiding the use of topical antibiotics that may cause antibiotic resistance.
- Continuous cleaning of ulcers and careful healing of open wounds to prevent air crossing, which includes removing dead layers.
- In case of large, painful ulcers and unresponsive to provisional treatment methods, surgical intervention is required for skin grafting.

Complications of Venous Ulcers:
If you do not undergo appropriate treatment, the patient may begin to suffer from the following:
- Inability to move.
- Osteoarthritis and Osteoporosis.
- Septicemia.
- Damage of superficial nerves.
- Bacterial infection.
- Skin inflammation and eczema.
- It may rarely happen when treatment is ignored, to develop into cancer.

Prevention of Venous Ulcers:
Venous Ulcers can be prevented by controlling risk factors that increase the chances of developing rosy leg sores through the following:
- Excess weight loss and consequent blood pressure control.
- Exercise daily.
- Ensure that the skin is healthy by hydrating it with moisturizing creams to prevent dehydration or cracking.
- Stay away from fatty foods to control blood lipid levels.
- Reduce the amount of salt in the diet.
- Therapeutic follow-up in the case of a previous history of venous ulcers, for the high incidence of ulcers again in these patients.

Dr. Waleed El-Daly's Tips for Venous Ulcers:
1- A balanced and effortless walk helps to stimulate blood circulation.
2- Raising the leg to 45 degrees reduces the burden on the veins; This facilitates the healing process due to the flow of blood through the veins by gravity without the need for veins voltage.
3- Drinking healthy fluids in large quantities.
4- Sticking to prescribed surgical dressings and number of spare times.
5- Sticking to antibiotics and prescribed drugs.
6- Regular follow-up with the doctor on the likelihood of needing to remove some unhealthy tissues that may cause bacterial infection if their presence persists.
7- Wear appropriate shoes and socks.
8- Signs to watch out for and communicate quickly with your specialist doctor when they occur:
* New redness and swelling of the skin around the ulcer accompanied by high temperature.
* A new and continuous change in the colour of the toes or leg.
* The appearance of green or foul secretions or the emission of stink odor from ulcers.
* Increased leg pain that disappears with natural painkillers.
* Increased numbness.
* Unusual increase in leg swelling.
* The appearance of a new wound.