Varicose : Preventable Complications

What is phlebitis? ` by Leanna L. Beaumont MSN, APNP Phlebitis, or superfi cial Leanna is a board certifi ed nurse practitioner. (STP), is a condition She is a member of the American College of Phlebology in which a blood clot forms in one and the American College of Nurse Practitioners. of the superfi cial veins of the body She works with Dr. Terry Gueldner MD, FACS, RPhS causing infl ammation and tenderness at The Wisconsin Center in Manitowoc, of the vein. This typically affects the (920) 686-7900. veins in the legs, but can occasionally occur in other areas. aricose veins, phlebitis and What are venous stasis ulcers? Symptoms of an STP include warmth, redness and tenderness over open sores on the legs: Open sores which develop as a result the affected vein. The vein might also What are they? Can they of venous refl ux are referred to as feel fi rm and cordlike because of the be related? venous stasis ulcers. Fluid accumulation V clotted blood inside it. The diagnosis Veins are blood vessels which in the legs makes it diffi cult for the cells of STP can be confi rmed with a duplex return blood to the heart and lungs in that area to obtain the necessary ultrasound evaluation of the veins. so it can be re-oxygenated. This nutrients or effectively remove the The duplex ultrasound also is used to means that blood in the veins should waste products. Gradually the skin in evaluate for the presence of a more move up out of the legs toward the the legs becomes malnourished and dangerous deep vein blood clot. heart. Bulgy are an fragile. Left untreated, open sores indication that there is blood fl owing might ultimately develop. Venous Are all blood clots the same? backward down some veins instead of stasis ulcers are not a normal part of No. There are two systems of up toward the heart. This backward aging; they are the result of a treatable veins moving blood up and out of fl ow of blood is called venous refl ux venous insuffi ciency disorder. your legs—a deep vein system and or venous insuffi ciency. Over time, Venous stasis ulcers are the most a superfi cial vein system. The deep venous insuffi ciency leads to the common type of ulcers on the lower system veins are of large diameter and pooling of blood in veins. This causes legs affecting 500,000 to 600,000 situated close to the bone, surrounded fl uid to accumulate in the legs and Americans annually. These ulcers are excess pressure to develop in the veins typically located below the knee in DVT RISK FACTORS causing them to stretch and dilate. the ankle area. Some venous Varicose veins are an indication of stasis ulcers are quite PROLONGED SITTING, venous insuffi ciency. Open sores on painful while others the legs and phlebitis of the veins are BEDREST OR RESTRICTED are virtually MOBILITY OR BEDREST complications which can develop from painless. advanced venous insuffi ciency. OVER AGE 40 SURGERY OR MAJOR INJURY The borders of SMOKING the ulcer are generally irregularly shaped and often CANCER surrounded by discolored and EXCESS WEIGHT swollen skin. Fluid drainage from the ulcer is also common SEDENTARY LIFESTYLE and might or might not PREGNANCY indicate infection. HORMONE THERAPY

HOLIDAY 2012 | 1 HEALTH | prevention by muscle. They are responsible for returning about STP or venous stasis ulcers, treatment of any underlying 90 percent of blood from your legs back to the heart and vein disorders including varicose veins might prevent these lungs. The superfi cial system complications from occurring at all. veins are located in the tissue Defi nitive venous insuffi ciency under the skin, and at times are treatments have improved visible. They do not communicate dramatically in recent years and directly with the heart and lungs. typically include a combination of Deep vein (DVT), laser closure of veins, injection or blood clots which occur in sclerotherapy, and microphlebectomy the deep veins, can be a serious (mini vein removal). All of these condition. The risk is that the treatments can be performed blood clot breaks free of the leg comfortably in an offi ce-based veins and travels to the lungs setting without the need for impairing the body’s ability hospitalization, general anesthesia to deliver oxygen. Blood clots or sedation. Down time following that occur in the superfi cial these treatments in minimal with the leg veins, or superfi cial BEFORE AFTER ability to return to work and normal thrombophlebitis (STP), can be TREATMENT TREATMENT activities immediately. quite uncomfortable but pose a Venous insuffi ciency is treatable much lower risk of breaking free and traveling to the lungs. and the associated complications are preventable. Early In about 40 percent of STP cases, however, there is also identifi cation and treatment is essential. If you think you a DVT present. For this reason it is extremely important to may be at risk for venous disease, ask your healthcare contact your healthcare provider for a thorough evaluation if provider it. Help is available! ƒ you think you might have developed a STP. ADVERTISEMENT How are venous stasis ulcers, STP and varicose veins related? Unsightly, Painful The presence of varicose veins is a sign of a venous insuffi ciency disorder that increases the risk of developing STP or a venous stasis ulcer. Symptoms of venous Varicose insuffi ciency include aching, throbbing or burning of the legs especially with prolonged standing or sitting. Swelling of the & Spider legs or feet that worsen throughout the day, skin discoloration of the lower legs, or the development of varicose veins are also symptoms of venous insuffi ciency. Venous stasis ulcers Veins? and STP are complications that can develop as a result of untreated advanced venous insuffi ciency. We can help! • All didiagnosisagnnosio sa andnd tretreatmentatatmmentt donedod nne How are conditions treated? in the comfort of our of¿ ce The short-term goals of venous insuffi ciency treatments • Quickly return to work and activitieses • Personalized treatment plans are directed at reducing associated pain and infl ammation, • Covered by most insurances improving leg swelling, healing venous stasis ulcers, and limiting complications from venous insuffi ciency. Medical EXPERT VEIN CARE at a practice grade prescription strength , periodic devoted exclusively to state of the art leg elevation, walking, and over-the-counter medications vein diagnosis and treatment. such as are all used for this purpose. Long-term management of these venous insuffi ciency 940 Maritime Dr disorders includes preventing a recurrence of the condition Manitowoc once it is treated. A thorough evaluation by a vein specialist 920.686.7900 is important. Identifying and treating any underlying vein disorders that contribute to the development of STP, www.homeofhappylegs.com © venous stasis ulcers and varicose veins can prevent a “The Home of Happy Legs” Terry L. Gueldner, MD, FACS, RPhS recurrence. In individuals who have not suffered from a division of Premier Surgical of WI, S.C. Leanna L. Beaumont, MSN, APNP

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