Venous Ulcers

There are 6 steps in a in Chronic Venous Disease Classification Ladder (CEAP)

• 0 - No visible or palpable signs of venous disease
• 1 - Telangiectasias or reticular veins
• 2 - Varicose veins or Recurrent varicose veins
• 3 - Edema
• 4a - Skin pigmentation or eczema (legs)
• 4b - Lipodermatosclerosis or atrophie blanche
• 4c - Corona phlebectatica (bluish veins on ankle area)
• 5 - Healed venous ulcer
• 6 - Active venous ulcer or Recurrent active venous ulcer

Open venous ulcer, is the last step of Chronic Venous Disease Classification Ladder (CEAP) ladder.

Stasis dermatitis- CEAP: 4a

Stasis dermatitis is an eczematous eruption that occurs on the lower legs in some patients with chronic venous insufficiency (CVI). In early stages, it presents itself as a dry rash on the lower legs that gets worse with scratching. Over time, it progresses to broad areas of redness and scaling, eventually leading to brown discolorations and significant skin atrophy and/or ulceration.

Venous Ulcers and Arterial Ulcers

What may be obvious to some is not always clear to others, even for people within the medical profession. It is even more difficult for the average patient to say what is or is not a venous leg ulcer.

Venous leg ulcer is a result of prolonged incompetence (reverse blood flow) or obstruction in veins, hence a venous ulcer. On the other hand, an arterial leg ulcer is a result of severe deficit of arterial blood supply to an extremity, usually a result of severe atherosclerosis and PAD.

What if an ulcer is due to combined venous and arterial insufficiency?

• In patients with chronic, long lasting or/and poorly controlled Diabetes mellitus, ulcers might represent compromised microcirculation and/or advanced peripheral neuropathy.
• On rare occasions, a leg ulcer might represent a metastatic malignant lesion. Bedridden patients might develop pressure ulcers. Severe skin infection might lead to ulceration as well.

It is important to understand that the treatment of arterial ulcers requires a different approach than the treatment of venous ulcers.

• Treatment of venous ulcers does not require a hospital stay. In early stages it often involves gentle debridement of infected skin and wound, systemic or topical antibiotic to treat secondary bacterial infection, and several applications of customized dressings with multilayer compression. Once ulcer is healed, reverse blood flow, in varicosities that caused ulcer, has to be corrected.
• Arterial ulcers are usually treated with arterial stent, or arterial bypass grafting done in a hospital setting.

Based on our experience with treatment of venous ulcers we can say that with combination of treatments, most ulcers can be healed in a few weeks.

We encourage you to schedule a consultation with Dr. Jozef Tryzno, MD, Diplomate of the American Board of Venous & Lymphatic Medicine, Registered Vascular Technician. Call International Vein & Skin Institute today.
Call: (847) 518-9999

Disclosure: Every patient is unique, and cosmetic results can vary between patients. No two treatments will get same results – even if performed by the same physician on patients with similar conditions.