East Coast Podiatry
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Last Updated: 06 Jan 2021

Venous Insufficiency, Stasis, and Ulceration

Wound Dressing

A commonly overlooked lower limb condition is one caused by veins. When the veins don’t work well, they don’t return blood in the limbs back to the heart efficiently. This is called venous insufficiency and can lead to venous thrombophlebitis, venous stasis, dermatitis, and ulceration.

Veins have one-way valves that help to move blood back to the heart. If the veins widen or distort, then these valves do not meet and cause blood to flow backwards to the ankles and feet. This is often termed pooling; over time it is noted that blood often leaks from the veins into the surrounding skin and results in a darkening of the extremity. Patients often notice their lower legs turning darker in colour, a feeling of heaviness sets in, and veins may be seen visibly coiling.

Patients with this condition notice that the ankles swell during the day. With rest and leg elevation the swelling decreases, but this does not resolve without treatment. Neglect of venous problems in the lower extremity can lead to leg ulcerations and amputations at a later stage.

Varicose Ulcers


  • Feeling of heaviness in the legs
  • Taut, thickened and darkened skin of lower limbs
  • Hair loss on shins and feet
  • Frequent leg cramps
  • Foot and ankle swelling (decreases with rest and elevation)
  • Varicose and spider veins (twisted, bulging, dark purple or blue veins)
  • Dryness and itching
  • Pain
  • Skin sores that ooze, crust or look scaly

This condition is common in those who:

  • Are over the age of 50
  • Frequently fly
  • Stand or sit a lot for work
  • Are quite sedentary in lifestyle
  • Have comorbidities such as overweight, high blood pressure, kidney failure, history of DVT (blood clot in leg), or congestive heart failure (CHF)
  • Have varicose veins
  • Went through multiple pregnancies
  • Underwent surgery or injury in the lower limb

What can my podiatrist do for me?

Podiatrists are experts at lower limb care. When it comes to vein problems, podiatrists can handle the non-surgical aspect of care. Your podiatrist can quickly diagnose the cause and problem and offer real time solutions for fast and effective recovery. Typically, even a large venous ulceration can heal in less than 2 months given the correct care and treatment.

  • Specialised wound care if wounds are present
  • Specialised compression bandaging
  • Long term compression treatment
  • Lower limb offloading
  • In-clinic treatment for enhancing limb circulation and wound healing
  • Prompt referral for vascular surgery if required

Why is compression so important?

Compression is one of the mainstays of treatment for venous insufficiency. Appropriate compression reduces tissue swelling by pushing the excess fluids that build up inside the legs back into the blood vessels. The compression will also prevent the veins in the leg from excessive expansion, normalizing venous blood flow and preventing it from flowing backwards. Increasing this venous flow helps speed up wound healing, decreases leg discomfort, and assists in preventing infection.

Compression will reduce oedema surrounding the wound/ulcer; the surrounding tissue around the wound/ulcer will then be able to receive the oxygen needed to facilitate healing. Using compression therapy combined with appropriate wound care, in many cases venous leg ulcers can heal faster than standard wound care alone.

Specialist knowledge, a hands-on skillset, and optimal handling of complex wounds mean that lower extremity venous conditions can have a good outlook. Our team of podiatrists will ensure a proper application of both therapy and wound dressing to help heal leg ulcers, preventing infection and leg amputation.

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