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Living with Your Venous Ulcer

A Guide for Patients and Caregivers

This guide is for you, our patient, and any caregivers who may be involved in your care.

This guide explains how we can help you to help your Venous Ulcer. It is full of information to help you to understand what it going on with yoru body when you have a wound and what your body needs to heal the wound or, if it can't heal, to feel better. 

What is a Venous Leg Ulcer?

A venous ulcer occurs when blood in your veins can no longer flow back up your leg correctly. Instead, the blood beings to pool creating pressure in your veins. The blood eventually leaks into your tissue and begins to cause tissue and skin damage. This is called chronic venous insufficiency (CVI).

CVI AND WOUNDS

If you get a wound on your leg from a bump or a scratch, because of the underlying CVI and swelling, you may have trouble healing it. We call this kind of wound a Venous Leg Ulcer (VLU). The ulcer wasn’t caused by your CVI, but the healing is impaired due to your CVI. Your nurse will teach you how you can help your ulcer to heal by changing your dressings and wearing compression wraps and stockings.

CVI AND COMPRESSION

If you have CVI, you will need to use compression on your lower legs (from toe to knee) in the form of wraps or stockings, for life. Compression wraps are bandages that help the valves in your leg to work more efficiently. This means that the blood will flow up the legs the way it is supposed to. Initially you will use compression wraps to get the swelling down in your legs. The wraps will be applied by your nurse 2 or 3 times per week.

Once the swelling is reduced and your wound is healed, you will be measured for stockings. It takes time to get used to wearing compression all the time. You may find that you need to buy bigger shoes, and sometimes the compression wraps make your legs warm. Do your very best to stick with the compression because this is the most important part of your therapy and will actually make you feel better and reduce your risk for more ulcers over the long term.

LOWER LIMB ASSESSMENT

• Before you start wearing compression, your nurse will need to assess the arteries in your legs to ensure that your legs will not be harmed by the compression. The nurse will ask you questions and look at both legs for signs of CVI. The nurse will also do a blood pressure test on your legs to assess the arterial blood flow to your feet. This is called an Ankle Brachial Pressure Index or ABPI. It will not hurt.
• The ABPI does not tell you that you have CVI; it only confirms that it is safe to use the compression therapy on your legs. It is your medical history and the way your leg looks that tells the doctor or nurse that you have CVI. If you are using compression, you should have the ABPI repeated twice a year.

Things I Can Do To Help My Venous Ulcer Get Better

Blood Flow

• I will wear my compression wraps or stockings as recommended by my doctor or nurse.
• I will elevate my legs above the level of my heart every day for at least an hour.
• I will put blocks under the foot of my bed to assist with raising my legs up during the night.
• When sitting, I won’t let the seat cut into the back of my legs, cutting off my circulation.
• When sitting, I won’t cross my legs or ankles.

Skin

• I will moisturize my skin with pH balanced, non-perfumed moisturizers daily.

• I won’t use antibacterial soaps, peroxide, iodine or alcohol on the skin around my wound as this can dry it out.

Activity to Increase Circulation

• I will check with my doctor to see if it is okay to start a regular walking program. If it is, I will start one.
• I will go for walks every                                                                                               
• I will use the treadmill                                                                                                 
• If I am sitting or standing for long periods, I will get up and walk around every half hour.
• If I am overweight, I will try to start a weight reduction program.