Healing Fact:

 Venous leg ulcers account for up to 80% of all lower-leg ulcers, making them the most common chronic wound affecting the legs.

Many people think poor circulation means one thing.

It doesn’t.

One of the biggest misconceptions I encountered during my nursing career was hearing patients say,

“I have poor circulation.”

My next question was always:

“Do you know if it’s your arteries or your veins?”

The answer matters because the treatment is completely different.

Venous leg ulcers develop when blood can travel down the arteries into the legs but struggles to return to the heart through the veins. Tiny valves inside the veins normally keep blood moving upward. Over time, those valves can weaken or become damaged, allowing blood to pool in the lower legs.

As pressure builds inside the veins, fluid leaks into surrounding tissues. The skin becomes swollen, fragile, and eventually may break down into an open wound.

What Causes Venous Leg Ulcers?

Several conditions increase the risk, including:

• Varicose veins
• Previous blood clots
• Chronic swelling
• Obesity
• Standing for long periods
• Limited mobility
• Aging

These ulcers usually develop slowly rather than suddenly.

What Do They Look Like?

Venous ulcers most often appear around the inside of the ankle or lower leg.

Common signs include:

• Leg swelling
• Brown or reddish skin discoloration
• Aching or heaviness
• Shallow wounds
• Drainage
• Irregular wound edges

The surrounding skin often becomes thickened and discolored long before the wound appears.

Why Compression Helps

One of the biggest surprises for patients is learning that compression stockings or wraps are often one of the best treatments.

Compression gently supports the veins, helping blood return toward the heart instead of pooling in the lower legs.

Walking also helps.

Every step acts like a small pump that assists circulation.

From a Nurse’s Perspective

I once cared for a woman whose venous ulcers required daily dressing changes for months. The wounds affected far more than her legs. They limited her mobility, interrupted her sleep, and made her reluctant to leave the house because of drainage and bulky dressings.

What helped wasn’t one miracle dressing.

It was treating the circulation problem underneath the wound.

Healing Takeaway

Venous ulcers are more than skin problems—they’re circulation problems.

Treating the wound is important, but improving blood flow back to the heart is what gives healing its greatest chance for success.

Next, we’ll look at arterial ulcers, where the problem isn’t blood getting trapped in the leg—it’s blood not reaching the tissues in the first place.