Venous stasis is a pooling of blood in the veins. A venous stasis ulcer is a wound on the skin caused by the pooled blood. These ulcers occur most often on the legs.

Causes

Veins have a series of valves that help the blood move in the right direction. When these valves fail to work properly, blood can move backward and pool in the veins. The pooled blood pushes fluid and blood cells out of the veins and into nearby tissue. The leaked fluids irritate the tissue and cause inflammation. Over time, the inflammation can breakdown tissue and lead to ulcers.

Risk Factors

Factors that may increase your risk of venous stasis include:

Diseases or conditions of the veins, including:
- Deep vein thrombosis
- A defect at birth
- Varicose veins and surgery to treat varicose veins
- Phlebitis —inflammation of vessels
Trauma to leg or veins
Obesity
Family history of chronic venous disease
Heart failure
Inactivity
Injection drug use

Smoking is harmful to blood vessels. It may play a role in venous stasis.

Varicose Veins

Symptoms

An ulcer is present for more than 4 weeks. Venous stasis ulcers may:

Be painful and itchy
Be discolored, darkened, and scaly skin around the edges
Have foul-smelling discharge from the wound if an infection is present

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. The diagnosis can often be made based on this information.

An ultrasound may be done. It can help to see how deep the wound is. It can also show blood flow to the area.

Treatment

The ulcer will need some time to heal. It usually takes 4 weeks or more. Special dressings are usually needed. They can protect from infection and speed healing.

Excess fluid can cause irritation and further damage. The excess fluid will need to be moved away from the area. Options include:

Compression stockings
Elevate the affected limb above the heart when sitting
Exercises—muscles help to pump fluid out of the area

Medicine may also help to improve blood flow. The medicine may be a pill or applied right to the skin. Options may include:

Statins
Aspirin
Pentoxifylline—reduces the thickness of the blood

Other medicine may be applied to the skin to help healing.

Surgery may be needed for larger wounds to:

Remove dead or infected tissue
Place healthy skin over the wound to help healing

Prevention

Venous stasis ulcers often happen again. Managing venous stasis will help prevent future ulcers. Factors that may help include:

Use of compression stockings
Weight reduction in people with obesity
Treating any cause of the venous stasis

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

Society for Vascular Surgery
https://vascular.org

CANADIAN RESOURCES:

Canadian Vascular Access Association
http://cvaa.info

Health Canada
http://www.canada.ca

References:

Collins L, Seraj S. Diagnosis and treatment of venous ulcers. Am Fam Physician. 2010;81(8):989-996.

Venous insufficiency and ulcers. New York-Presbyterian website. Available at:
...(Click grey area to select URL)
Accessed August 17, 2017.

Venous leg ulcer. NHS Choices website. Available at:
...(Click grey area to select URL)
Updated February 2, 2016. Accessed August 17, 2017.

Venous leg ulcers. Patient website. Available at: https://patient.info/health/venous-leg-ulcers-leaflet. Updated August 1, 2016. Accessed August 17, 2017.

Venous ulcer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115837/Venous-ulcer . Updated September 18, 2016. Accessed August 17, 2017.

Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 8/22/2018

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