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Venous skin ulcers develop when the
lower leg veins and calf muscles are weakened and cannot efficiently move the
blood back toward the heart. Pooled blood and fluid in the lower legs then
leads to tissue breakdown. You can prevent or heal a venous skin ulcer by
helping your blood circulate back toward your heart.
During sleep. While you
are sleeping, you can help your blood circulate back to your heart by elevating
your feet above the level of your heart. Prop the foot end of your bed up on
6 in. (15.24 cm) to
8 in. (20.32 cm) blocks.
While awake. During waking hours, try to elevate your legs
above the level of your heart for 30 minutes, 3 to 4 times a day.
Elevating your legs may be all the treatment you need if you have mild
venous insufficiency. But if you continue to have
problems with venous skin ulcers, you will need additional treatment.
Doing regular foot and ankle exercises can
help strengthen your leg muscles and improve blood flow in your legs. While you
are sitting (or standing), flex your ankles by pointing your toes away from you
and then pointing them up. Do 10 repeats of the exercise several times each
day. This exercise is especially important for people who need to sit or stand
for long periods of time.
Walking is also good exercise for
improving blood flow in the legs.
Compression therapy is the main
treatment for venous skin ulcers. If you have a venous skin ulcer, your
doctor may first want to reduce the buildup of fluid in your lower
leg. After your lower-leg swelling has been
reduced, compression is used to create more constant pressure on both the
flexing and resting leg muscles. There are several types of medical devices for compression therapy. If you have an
open wound, it will be covered with a dressing before the compression device is
Unna boot. This is a stiff bandage made with
gauze and zinc oxide paste wrapped around the lower leg. This type of bandage
improves blood flow by putting greater pressure on leg muscles when they are
flexing and less pressure on the leg during rest. It is used to reduce a large
amount of swelling in your lower legs. An Unna boot can be left on for 7 to 10
Long-stretch bandage or short-stretch bandage. These are flexible
bandages that are wrapped tightly around the lower leg to reduce swelling and
improve blood flow. The bandages are
used to help heal a venous ulcer. The ulcer is covered with a dressing before
the bandage is put on. The bandage is put on the leg by a health professional. Caregivers can be trained to apply them too.
Active compression pump.
This pump goes around your lower leg. It has air bags that inflate
and deflate periodically to force blood to flow out of your lower leg toward
your heart. The pump can be used to help heal a venous ulcer
that has not been helped by other types of treatment. The pump is used for several hours each day. It is used along with compression stockings.
Compression stockings. Specially fitted compression stockings are designed to help prevent
blood from pooling in the legs. You should wear
these stockings every day from the time you wake up until you go
to bed. Remove them only for bathing and sleeping. They can help venous skin ulcers heal and help prevent them from coming
For tips on using compression stockings see:
August 17, 2012
E. Gregory Thompson, MD - Internal Medicine & Margaret Doucette, DO - Physical Medicine and Rehabilitation, Wound Care, Hyperbaric Medicine
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