Venous

Venous wounds, which may also be called venous stasis wounds or stasis ulcers are wounds that form primarily on a person’s lower extremities.  They form for a variety of incidental reasons but are caused by an underlying condition that creates edema in the extremities. 

Edema is excessive tissue fluid.  It is caused by the circulatory system’s inability to fully return blood to the heart.  When not all blood is regularly returned to the heart, some seepage may occur from the veins and into surrounding tissue.  That seepage is the edema.

Edema can be detected by gentle pressure of the fingers against the skin.  Pitting edema leaves indentations for several seconds to minutes and implies excessive interstitial or tissue fluid.  At times this fluid becomes so excessive that the skin becomes taut and pitting is not possible.  This degree of edema will inhibit tissue healing, but healing may also be compromised by the inability of the circulatory system to do its job within the body – delivering healthy blood and returning fluid appropriately.

Elimination of Edema is the primary requirement for improving venous wounds. 

Unlike pressure wounds, diabetic wounds, or burns that are described by stage, category, or degree; venous wounds are described as either partial or full thickness.  Partial thickness wounds present with damage to the epidermal and to, but not through dermal tissues, while full thickness wounds present with damage to epidermal, dermal, and subcutaneous tissues – often involving deeper structures such as fascia, muscle and/or bone.

In order to appropriately establish wound type and etiology, a thorough wound assessment should be completed as required by state and federal guidelines. 

This thorough initial wound assessment or wound reassessment (as a component of a wound status change) is described AHS’ Assessment Guideline.  It requires a detailed assessment of the whole patient and their history as well as other factors including duration of the wound, patient’s recollection of the causative factors, complaints of pain, fever, numbness or drainage.