Venous UIcers and Wound Care

diabetic wound care

Venous ulcers are not only common, they are most often misdiagnosed. This situation can be exacerbated when wounds become chronic, due to difficulties in healing.

While it is a normal, everyday process to shed and replenish the outer layer of skin cells, one should consult a physician immediately if the skin becomes too thin, which often leads to venous ulceration.

While different categories of ulcers exist, the most prevalent ulcers are known as venous stasis ulcers. Venous stasis ulcers typically present themselves in the lower leg, near the ankle area. As with varicose veins, deficiencies or damage to the one-way valves in the veins can cause blood to pool or flow backward. This leads to several problems: improper blood flow inhibits the ability of the veins to carry nutrimental blood to all areas of the body. The pooling of the blood causes veins to swell, which is the typical presentation of varicose veins. The swollen superficial veins place additional pressure on the skin, increasing the probability of skin breakage, bleeding, and venous ulcers.

While diabetes is a factor for venous ulcers, other common factors should be noted, such as advanced age, surgery, and significant weight gain or long-term obesity. Senior citizens typically experience diminished vein function and thinning of the skin, and therefore the risk may be higher.

Persons with varicose veins should note that the condition of varicose veins, if left untreated, may predispose one to venous ulcers. Varicose vein treatment, as well as spider vein treatment, can be performed quickly and painlessly, with little down time or expense.

While malfunctioning veins or varicose veins can lead to skin ulcers, they are frequently precipitated cuts, scratches or bruises. These minor injuries fail to heal properly due to the compromised circulation of venous insufficiency, resulting in ulceration. These ulcerous lesions are often painful and unsightly.

It is an unfortunate tendency of many patients to assume that a venous ulcer will heal on it’s own, however, venous ulcers most often require treatment from a vascular specialist. Many patients initiate a self-treatment of applying antibiotic ointments, which actually does not assist in healing. Unprescribed antibiotic use can lead to antibiotic resistance, while the underlying ulcer persists or may even worsen over time.

Treating venous ulcers at the earliest possible sign is important, not only to prevent infection, but also due to the fact that continued ulceration of the skin leads to (sometimes irreversible) deterioration of the surrounding tissue.

A vascular surgeon, such as the board certified vascular doctors at the San Diego Vascular Center, can determine and supervise the best course of treatment. Zinc paste may be applied to facilitate healing and immune response. Several types of bandages are applied to compress the veins, which helps prevent the pooling of blood in the veins. If the skin or deeper tissues have been damaged by the ulcers, the tissue would need to be removed either by surgery or laser, to prevent tissue death (gangrene).

The underlying varicose veins may be treated by means of radiofrequency or laser ablation, which safely closes the faulty veins, allowing the body to reroute blood flow to healthier veins. This further allows the surface tissue to heal.

Venous ulcers may take weeks or months to heal on their own, during which they are at high risk of infection.
A wound is considered chronic if it does not show marked improvement within 3-5 weeks. Chronic wounds require regular visits to a vascular doctor to assess, clean, dress, and reapply compression bandages. In between visits, patients should inspect for signs of swelling, discoloration, pain, and signs of infection such as odor, pus, heat, or fluid drainage.

Diabetics should be particularly proactive with regard to wound symptoms, as heightened blood glucose levels impair circulation.


In short, it is highly recommended to have spider veins and varicose veins treated, even if they are not yet painful or ulcerated. Any signs of ulcers should be looked at immediately by a vascular doctor, and treatment regimens should be adhered to with regularity.


The San Diego Vascular Center is San Diego’s premiere practice of Board Certified Vascular Surgeons. We specializes in treating all vascular health issues, from varicose veins to wound care, for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.