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Got a Leg Wound? Could Be a Vein Problem

Got a Leg Wound? Could Be a Vein Problem

Do you or a close family member have a wound around the ankle that has been there for a while and doesn't appear to be healing? You may be surprised to know that leg vein problems are one of the most common causes of leg wounds around the ankle and lower leg. The good news is that this problem is nearly always treatable. The wounds start healing just days after an effective treatment is initiated.

One or more of the following symptoms and signs listed below may occur as a result of poor blood flow (circulation) in your legs.

Spider veins and varicose veins are common signs of poor blood flow (circulation) in the legs.  Other common signs or symptoms of leg vein problems are leg swelling, scarred skin, skin discoloration, and open sores. 

Leg vein problems are categorized according to severity based upon a 1-6 scoring system:

Class I = Spider Veins:

Small thread-like veins are mainly of cosmetic concern.

Class II = Varicose Veins:

Dilated skin surface veins that often bulge or protrude through the skin surface (see photo #2 above).

Class III = Edema / leg swelling:

People with venous insufficiency often report that their legs feel a little tired and perhaps a little swollen. Typically this happens over a course of a few months. 

Class IV = Skin Discoloration / Irritation:

Reddish or brownish discoloration of the skin between the ankle and the upper calf is a common consequence of vein problems. When this problem is associated with inflamed / irritated skin the term "stasis dermatitis" is often used.

          "stasis" means pooling, static, not moving.

          "derm" means skin.

          "itis" means inflammation. 

Stasis dermatitis can cause the skin to go from soft and pliable to thick, angry, inflamed, and hard, almost like alligator skin.

Class V and Class VI = Healed Scars vs. Active Wounds

When you have vein problem, leg wounds commonly occur more easily and take longer to heal.  A surprisingly common injury that can result in skin damage to the lower part of the leg is bumping your leg against the dishwasher.

When vein problems are present the skin in the lower leg is often itchy. Fingernail scratching of itchy legs can result in layers of skin being scraped away, resulting in an open sore. The medical name for skin breakdown (wound) occurring in the setting of underlying vein problems is a venous ulcer

The most common underlying condition that causes leg swelling, skin discoloration, scarred skin, or open sores that don't seem to be healing well is venous reflux (also known as "venous insufficiency"). When the valves inside the veins are not working properly back-pressure can build up, causing low-grade aching discomfort, leg swelling, skin discoloration, and wounds around the ankle.

To evaluate whether venous insufficiency or venous reflux could be the cause of a leg wound a vascular sonographer will perform a thorough scan of your entire leg for an accurate diagnosis.

Most people with leg conditions mentioned above are candidates for office-based procedures that seal closed the bad veins in the leg. This forces blood to redirect and divert to the good veins in the leg. The overwhelming majority of leg wounds will heal rapidly once the vein problem has been identified and corrected.

Vascular Solutions is Charlotte’s premier center for vein and vascular care. If you or a loved one has skin discoloration, skin irritation, or a wound in the lower leg or around the ankle, we highly recommend you calling us for an evaluation. The sooner you get treated, the sooner you can return to a pain-free normal lifestyle. Healthy legs, healthy life!




Peter Ford MD FACS RPVI Peter Ford, MD, FACS, RPVI, is a board certified vascular surgeon who works at Vascular Solutions in Charlotte, North Carolina. Dr. Ford specializes in the management of varicose veins and venous disease.

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