Venous Stasis Ulcer
(Hypostatic ulcer; Stasis ulcer)
A venous stasis ulcer is wound on the skin. It is due to a pooling of blood in the veins. These ulcers happen most often on the legs.
If left untreated, the ulcers can lead infection and other serious problems.
Venous stasis ulcers are caused by a problem in veins. Valves in the veins normally move blood in the right direction. When the valves fail, blood flows backward and pools in the veins. This pushes blood cells and fluid into nearby tissue. The leaked fluids irritate the tissue. Over time, inflammation causes ulcers to form.
Venous stasis ulcers are more common in women and people over 65 years old. Other things that raise the risk are:
- Vein problems, such as:
- Injury to the leg or veins
- Family history of long term vein disease
- Heart failure
- Injection drug use
Smoking is harmful to blood vessels. It may also play a role in venous stasis.
Venous stasis ulcers are often on the legs or ankles. Symptoms are sores that may:
- Be present for 4 or more weeks
- Cause mild to severe pain
- Be discolored, darkened, and scaly around the edges
- Have a bad smelling discharge—if infected
The doctor will ask about symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis.
The doctor may check blood flow around the ankle. This is done with a blood pressure cuff.
The goal is to heal the ulcer. Treatment depends on how severe the condition is.
Excess fluid can cause irritation and further damage. The excess fluid will need to be moved away from the area. Options are:
- Compression stockings
- Raising the affected limb above the heart when sitting
- Exercises—to help pump fluid out of the area
Medicine may also help to improve blood flow. The medicine may be taken by mouth or applied to the skin. Options may be:
Other medicine may be applied to the skin—to help healing, ease pain, and prevent infection.
Surgery may be needed for larger wounds to:
- Remove dead or infected tissue
- Place healthy skin over the wound to help healing
Venous stasis ulcers often happen again. Managing venous stasis will help prevent future ulcers. Things that may help are:
- Use of compression stockings
- Weight control—for those with obesity
- Treating any cause of the venous stasis
- Bonkemeyer Millan S, Gan R, et al. Venous ulcers: diagnosis and treatment. Am Fam Physician. 2019;100(5):298-305.
- Venous insufficiency and ulcers. New York-Presbyterian website. Available at: https://www.nyp.org/vascular/venous-insufficiency-and-ulcers.
- Venous leg ulcer. NHS Choices website. Available at: https://www.nhs.uk/conditions/leg-ulcer/
- Venous ulcer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/venous-ulcer.
- Dan Ostrovsky, MD
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