What is a Venous Ulcer? 
A venous ulcer (Venous ulcer) is a chronic wound caused by abnormal blood circulation in the veins, especially in the lower legs and around the ankles. When blood pools in the veins for a long time, the skin and tissues receive insufficient oxygen, resulting in wounds that are difficult to heal.This type of wound is one of the common complications of varicose veins and chronic venous insufficiency. If not properly treated, it can affect daily life and long-term quality of life. 

Causes and Risk Factors of Venous Ulcers 
- Chronic Venous Insufficiency (Chronic Venous Insufficiency) causes blood to flow backward and pool in the veins 
- Varicose Veins (Varicose Veins) are abnormally swollen and enlarged veins 
- Deep Vein Thrombosis (DVT) causes narrowing of the veins 
- Genetics and Age the risk increases with age 
- Overweight or Obesity increases pressure in the veins 
- Lifestyle Habits such as prolonged standing, sitting, and lack of exercise 
Symptoms of Venous Ulcers 
- Chronic wounds that heal slowly, usually around the ankles 
- Skin around the wound changes color to dark, discolored, or thickened 
- Swelling, pain, or leg discomfort, especially after prolonged standing 
- There may be lymph or clear fluid oozing from the wound 
- If infected, symptoms may include severe pain, redness, swelling, and unpleasant odor 
Diagnosis of Venous Ulcers 
Doctors will perform a physical examination and take a detailed medical history, and may recommend additional tests such as Doppler Ultrasound to assess vein function and blood flow. 

Care and Treatment Guidelines 
1. Proper wound care to reduce the risk of infection and promote wound healing 
2. Wearing medical compression stockings (Compression Therapy) to help reduce blood pooling and relieve swelling 
3. Medication such as antibiotics if there is an infection, or anti-inflammatory drugs as prescribed by a doctor 
4. Procedures or treatments for varicose veins such as laser therapy, sclerotherapy, or surgical removal of varicose veins in some cases 
5. General health care such as elevating the legs when resting, regular exercise, and maintaining a healthy weight 
Complications to Watch For 
1. Skin infection (Cellulitis) 
2. Wound progression and slow healing 
3. Pain and limited mobility 
4.Impact on quality of life and daily activities 

Prevention of Venous Ulcers 
1. Avoid prolonged standing or sitting 
2. Exercise regularly to stimulate blood circulation 
3. Maintain a healthy weight 
4. Wear medical compression stockings as recommended 
5. Take care of the skin and hygiene of the legs to reduce the risk of wounds 
Venous ulcers require continuous care as they can lead to chronic wounds and complications that affect quality of life. Prevention through health care, behavioral adjustments, and regular check-ups is essential. 

If you suspect a venous ulcer or a chronic wound that heals slowly, you should seek evaluation from a vascular specialist and wound care doctor at Phyathai Hospital 2 to receive appropriate advice and personalized care. 

Dr. Supachai Janwitan

Vascular Surgery Specialist

Phyathai Hospital 2