Is there a difference between ‘venous ulcers’ and ‘pressure ulcers’?

Yes.  Venous skin ulcers are caused by poor circulation in the legs caused by damaged valves that prevent blood from flowing the wrong way, allowing blood to pool in the legs.  Pressure ulcers, on the other hand, are caused by sustained pressure on an area of the body, which cuts off blood flow.

A venous skin ulcer (also known as a stasis leg ulcer) is a small wound that occurs when the veins in the legs do not properly return blood back toward the heart.  Venous skin ulcers usually develop on the sides of the lower leg, above the above the ankle and below the calf.

Venous UlcersVenous insufficiency occurs when the valves that prevent blood from flowing the wrong way become damaged, allowing blood to flow backward and collect in the leg veins instead of flowing normally toward the heart.  This pooling of blood can cause the tissue to breakdown, forming an ulcer.

Causes of venous insufficiency include long-term high blood pressure inside leg veins and blood clots in leg veins (deep vein thrombosis or phlebitis).  Symptoms of venous insufficiency include swollen ankles, tight calves and aching in the legs.  These symptoms may be relieved by wearing compression stockings, elevating the legs, and avoiding standing for long periods of time.

There are certain risk factors for venous insufficiency and venous skin ulcers.  These include deep vein thrombosis (blood clot forms in the deep veins of the legs), obesity, pregnancy, family history of varicose veins, and lack of physical activity.  Nursing home patients may be at increased risk for venous skin ulcers because of little or no physical activity, poor blood circulation, and lying with legs below heart level.

A venous skin ulcer can be identified by the darkening of the skin (dark red or purple) where the ulcer is forming.  If left untreated, an ulcer can form, which can become infected.  A doctor should be notified immediately upon the first signs of a venous skin ulcer (darkening of skin) in order to prevent an ulcer from forming.  Venous ulcers can be prevented with the use of compression stockings and elevating the legs above the level of the heart in order to improve blood circulation.

A pressure ulcer (also known as a bedsore, pressure sore, or decubitus ulcer) is an area of damaged skin and tissue caused by sustained pressure, which cuts off blood flow to parts of the body resulting in areas of injured skin and tissue.  The areas of the body most vulnerable to pressure sores are the heels, hips, and buttocks.

Elderly nursing home patients are particularly vulnerable to pressure sores because of prolonged bed rest, limited mobility, and weakness.  Nursing home staff must turn residents who are bed ridden or have prolonged bed rest often enough so blood can circulate to areas that are under pressure.



Merck Manuals: Pressure Ulcers

WebMD: Pressure Sores

WebMD: Deep Vein Thrombosis

MayoClinic: Deep Vein Thrombosis

WebMD: Venous Skin Ulcer

MayoClinic: Bedsores