Venous Insufficiency

By Holly Hovan MSN, GERO-BC, APRN, CWOCN-AP

Lower extremity wounds manifest in a multitude of ways, with numerous causative or trigger factors. These types of wounds are often costly to treat, are frequently refractory, and have a high risk for recurrence. A comprehensive assessment and an evidence-based treatment plan, along with ongoing patient education and routine follow-up, are essential components of an effective plan of care.

Arteriography: Also called angiography, this technique is the medical imaging of blood vessels to look for aneurysm and stenosis.

Hemosiderin staining: Hemosiderin staining results in a red, ruddy appearance on the lower leg and ankle. This appearance is caused when red blood cells are broken down and not removed adequately as a result of venous insufficiency or another medical condition.

Phlebectomy: A minimally invasive procedure (usually outpatient) to remove varicose veins located near the surface of the skin.

Holly Hovan MSN, APRN, RN-BC, CWOCN-AP

Identifying wound etiology before initiating topical treatment is important. Additionally, correctly documenting wound etiology is significant in health care settings for many reasons. Accurate documentation and appropriate topical treatment are two critical components of a strong wound treatment plan and program. Bedside staff members should be comfortable with describing wounds, tissue types, and differentiating wound etiologies. Training should be provided by the certified wound care clinician, along with follow-up (chart reviews and documentation checks, one-on-one education as needed, and routine competency or education days). Additionally, the wound care clinician should be able to develop an appropriate treatment plan based on wound etiology, by involving additional disciplines as needed to best treat the whole patient.

By the WoundSource Editors

Before the mid-1990s, venous disorders and disease were classified almost solely on clinical appearance, which failed to achieve diagnostic precision or reproducible treatment results. In response to this, the American Venous Forum developed a classification system in 1994, which was revised in 2004. This classification system has gained widespread acceptance across the clinical and medical research communities, and most published papers now use all or part of the CEAP system (defined in the next section). This system was once again updated in 2020.

by Karen Bauer , NP-C, CWS

In my recent WoundSource webinar on management strategies of venous leg ulcers (VLU), I discussed the complex pathophysiology of VLUs and procedural interventions that can help them reach closure.

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

With the millions of people living with chronic wounds, there are also millions of people living with cardiovascular disease. Every year, there are approximately 670,000 Americans diagnosed with heart disease. This equals more than one person diagnosed each minute! The skin may be the largest organ, but the heart is most vital in circulating oxygen and nutrient-rich blood throughout your body. A healthy heart is a leading factor in wound healing. Cardiovascular diseases that impede healing include peripheral arterial disease, coronary artery diseases, heart failure, and other heart and vessel issues that can inhibit blood, oxygen, and nutrition in wound healing.

by the WoundSource Editors

Venous leg ulcers can be painful, cause distress, and affect quality of life, from the weekly wound center visits, multilayer wraps, debridements, compression hose, elevation of legs above the heart, to the odor from heavy exudate.

by the WoundSource Editors

Chronic non-healing venous ulcer wounds are an economic burden to the health care system and are the most common type of leg ulcer, affecting around 1% of the population, with 3% of people aged over 80. With obesity and diabetes on the rise, the burden is likely to continue to increase. Lowered quality of life, amputation, and death are often the results of venous leg ulcer chronicity, and the rate of recurrence within three months after wound closure has been reported to be as high as 70%.

by the WoundSource Editors

Venous leg ulcers (VLUs) are difficult to treat, and when they are present a variety of complications may arise. These complications can be challenging to treat and may often contribute to the prolonged healing times resulting from chronicity found with many VLUs. Further, if the condition of the ulcer deteriorates, it may worsen any complication already present or serve as the catalyst for the development of complications.

by the WoundSource Editors

A venous leg ulcer (VLU) is caused by vein disease that primarily affects older adults. As a prevalent problem among older patients, providing care for individuals with VLUs is time-consuming and costly. The direct costs vary from country to country, with reporting numbers of €800 monthly in Germany. Statistics report $2,500 monthly in the United States per patient, and given the chronic nature of VLUs, the cumulative costs per patient increase rapidly.