Venous ulcers are the most common found leg ulcers. Venous insufficiency is the inappropriate functioning of the one-way valves in the veins. Generally veins take blood from the feet, ankles and the lower legs to the heart. Venous disease affects the quality of life of the person infected and also the costs can be quite cumbersome. Although the pathological causes leading to this venous ulceration are unknown, a better realization of the current pathophysiology of ulceration will lead to novel approaches in its control and management. In addition to the compression therapy, latest kinds of wound dressings, surgical modalities, bioengineered tissue, topical and systemic therapeutic agents can be used.

Let us have a quick glance of how the venous ulcer affects the leg. Normally the veins taking the blood from the lower part of the body to the heart has two systems supporting the uphill flow of blood, namely the calf muscle pump which pumps the blood towards the heart and the one-way valves which obstruct the flow of blood back into the lower part. Any discrepancy in the calf pumping or any reflux through the valves or obstruction of the veins may cause the blood to accumulate from the lower part of the leg

to the ankle. Further pressure in the normal activity of the veins leads to fibrous deposits I around the capillaries. This then blocks the blood and oxygen flow to muscles and skin tissue. The tissues die due to this condition and it leads to ulceration.

There are also other kinds of ulcers called arterial ulcers, which differ from venous ulcers in characteristics. Typical features of venous ulcers are they are associated with aching and swollen lower legs which are comfortable when kept at an elevated position, they are located below the knee (mostly inner parts of the ankles), they are of mottled brown or black staining with dry, itchy and reddened skin, they sometimes make the lower part of the leg harder, they are often associated with swelling due to local inflammation, chronic inflammation might destroy lymphatic vessels causing edema resulting in scaling, fissuring and oozing.

Treatment of these venous leg ulcers normally requires proper exercise, elevation of the leg at rest, and compression. If arterial ulcer is also found, then compression must not be used. The first step is the cleaning of the wound, which involves removal of dead skin and the surface debris from the wound, and is called debridement. The wound might become chronic and infected to the tissue, in which case antibiotics like fluclaxacillin is used. Surgery might be necessary if the ulcer doesn't heal with antibiotics. First the stage of the ulcer is determined, and other associated diseases like thrombophilia (blood clotting tendency) and diabetes are controlled. Skin grafting can be used for chronic ulcers. The healing of the wound takes time, proper nutrition and attention towards it. Enough protein, Vitamin C, Iron and Zinc along with some supplements need to be taken. Compression therapy is a vital element for leg ulcers. It involves using a bandage which is wrapped around from the feet to the part of the leg below the knee. This creates pressure on the leg, increases the calf muscle pump and heals the ulcer. There are different types of compression therapy available like Unna boot (gauze bandage with zinc oxide), shaped tubular bandage, Elastic graduates compression hosiery and others.

To conclude, the best way to tackle venous leg ulcers is to prevent them before hand. Some of the precautionary causes are not to injure your legs, walk for atleast an half hour a day to keep the calf muscle pump functioning properly, maintaining healthy weight, staying away from and kind of alcohol consumption and smoking, cleaning your feet regularly and moisturizing them after bath, wearing comfortable footwear, avoiding standing for a long time in a single stance, avoiding sitting with legs crossed, avoiding exposing the legs to extreme hot and cold weathers, avoiding sitting for hours, and mostly having a healthy and a balanced diet.