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Severe, prolonged high pressure in the veins of the legs, known as chronic venous hypertension, may cause skin ulcers, or venous stasis ulcers, to develop. These ulcers may range in location from the mid-calf to the toes, but the most common location is near the inner aspect of the ankle. Infection in the ulcer may cause increasing pain, tenderness, and swelling. While local wound care, elevation, elastic compression, and treatment of infection may heal a venous stasis ulcer, treatment of the venous problem underlying the condition is essential to prevent recurrent ulcers.

For the same reasons that chronic venous hypertension may cause a venous stasis ulcer, it may also prevent healing of a minor traumatic skin wound. Minor wounds of the distal lower extremity should show signs of healing within a week.

Detailed venous evaluation is necessary to sort out the factors contributing to venous hypertension. They may include chronic venous insufficiency (failure of the one-way valves in the veins), venous obstruction in the leg or pelvis due to old clotting known as venous thrombosis, or obstruction of veins of the abdomen or pelvis due to other conditions resulting in compression of the veins. Arterial blockage may be a factor in poor healing of the limbs, especially in insulin-dependent diabetics and in smokers.

If you have a leg ulcer or poorly-healing wound, seek evaluation in a facility with the clinical experience and vascular laboratory support to properly evaluate the causes of the problem.

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