RISK FACTORS FOR VENOUS LEG ULCERS
We now understand the way leg ulcers develop from varicose veins and chronic venous insufficiency—the breakdown of valves in the veins and the swelling of tissues and so on.
However, why this happens with certain individuals and not with others is more difficult to pinpoint.
A brief overview of risk factors is listed below; some of these you can do nothing about, while others can be controlled. Over the years, some of these risk factors may have contributed towards gradually developing CVI and the subsequent venous ulcer.
Clients who had jobs which required long periods of standing, without muscular exertion: for example, hairdressers, pharmacists, factory workers, teachers, nurses, store clerks, and flight attendants.
Tight clothing can have an adverse effect on blood circulation.
Although the formation of varicose veins associated with pregnancy may be temporary, it has been shown the risk of developing varicose veins doubles with two or more pregnancies. In fact, it’s estimated that up to 40% of all pregnant women develop varicose veins.
Trauma or injury
A knock or injury to the leg or ankle can damage the skin and contribute to an ulcer developing if someone is vulnerable to venous leg ulcer formation.
Some studies suggest a link between being overweight (more specifically, being obese) and developing varicose veins. More weight puts above average pressure on the ankle joints, makes the heart work faster and contributes to high blood pressure. Also, being overweight means you have more blood and therefore the blood may “pool” in the lower legs.
Reduced physical activity has long been associated with venous disease. Remember, the calf muscle is responsible for the pumping function that pushes up venous blood from the legs to the heart. Obviously, if these muscles are not used, the venous blood is going to collect or pool in the legs and venous pressure will increase in the legs. The message here is use those calf muscles. If you do not walk much, just moving your feet upwards can help.
As with so many illnesses, smoking cigarettes can worsen the condition. The role smoking plays in venous leg ulcers and venous disease is that of damaging the blood circulatory system. Smoking narrows arteries and reduces oxygen within the blood vessels making the skin unhealthy. If someone has a venous ulcer it slows down the healing process because less oxygen and healing nutrients are getting to the damaged skin.
Direct heat to the leg
Avoid strong, direct heat from a lamp or electric heater, jaccuzzi or very hot baths. Although it may feel good in the short term, this type of heat can further damage the skin or aggravate an existing leg ulcer.
The skin is the part of the body that breaks down in a venous leg ulcer so it makes sense to try to keep it as healthy as possible so that it can defend itself against the venous blood circulation problems. The main objectives of skin care are to maintain soft, supple, clean and healthy skin and prevent irritation.
One study found that the risk of developing venous disease was doubled for people with a relative with the condition.
Deep vein thrombosis (DVT)
This is a medical condition that can contribute to varicose veins and venous leg ulceration but it is difficult to diagnose and its true prevalence is difficult to estimate.
As venous disease is a progressive, time-driven, destructive process, it is natural that varicose veins and associated venous disease will get worse over time.
Adherence to treatment (compliance) and self care
Treatment – like compression bandaging and stockings as well as many self help tips like rest and elevation of the legs – requires the cooperation and motivation of the person if it is going to be truly effective.