What are the main risk factors
for venous leg ulcers?

Before breaking down the key venous leg ulcer risk factors, it is important to understand what they are and how they affect patients.

Venous leg ulcers are defined as chronic leg wounds that take longer than 4 to 6 weeks to heal. Venous leg ulcers mostly occur on the inside of the leg, just above the ankle. They are the most common type of leg ulcer and are estimated to account for 60 to 80% of all cases.[1]

The main venous leg ulcer risk factor is chronic venous insufficiency. However, there are a number of other intrinsic and extrinsic factors that can increase your risk of developing a leg ulcer.

Age

The valves in the veins tend to weaken as we age. When the valves are damaged, the blood is unable to flow normally through the body. This makes us more susceptible to venous leg ulceration.

Obesity

Being overweight increases the pressure in your veins, which can increase your risk of venous insufficiency or worsen any existing symptoms of the condition. 

Previous Ulcer

Having a history of venous leg ulceration is one of the biggest risk factors for developing future ulcers.

Venous leg ulcer recurrence rates are estimated to be between 45-70%.[2]

Hereditary

A family history of chronic venous insufficiency is a useful indicator of venous leg ulcer risk levels.[3]

Impaired Mobility

Being immobile for an extended period of time means the calf muscle pump mechanism is not activated through movement (i.e., walking or standing). This makes it more difficult for the veins to transport the deoxygenated blood from your legs back up to your heart properly.

Deep Vein Thrombosis

Deep vein thrombosis is a condition that occurs when a blood clot forms in one or more of the deep veins, particularly around the legs.

These clots can damage the valves in the veins and increase the chances of developing a venous leg ulcer.

Varicose Veins

Varicose veins are swollen veins that typically occur on the lower limbs. Individuals with varicose veins are at an increased risk of venous leg ulcers because their veins are under high pressure.

Female Sex

Venous leg ulcer rates are higher in the female sex than they are in the male sex.[4]

Surgery In Lower Limbs

Surgical procedures such as knee or hip replacements can sometimes cause valve damage.[5]
Lower limb surgeries can also lead to reduced mobility, sometimes temporarily, which can increase pressure in the veins.

Smoking

Smoking has a negative impact on the flow of blood to the legs. Studies show that smoking can lead to delayed wound healing for existing leg ulcers.[6]

Prolonged Standing

Standing for a long time can accelerate the backflow of blood into the legs caused by incompetent valves in the veins.

References:

  1. S, Probst et al. Prevalence and Incidence of Venous Leg Ulcers: A Protocol for a Systematic Review. Systematic Reviews 2021; 10(148): 1
  2. Vowden, Kathryn R., Vowden, Peter. Preventing Venous Ulcer Recurrence: A Review. International Wound Journal 2006; 3: 11
  3. Ibid: 11
  4. S, Probst et al. Prevalence and Incidence of Venous Leg Ulcers: A Protocol for a Systematic Review. Systematic Reviews 2021; 10(148): 1
  5. Vowden, Kathryn R., Vowden, Peter. Preventing Venous Ulcer Recurrence: A Review. International Wound Journal 2006; 3: 11
  6. McDaniel, Jodi C. Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice. J Wound Ostomy Continence Nurse 2014; 41(5): 415

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Disclaimer:

Please note that while every effort is made to ensure the accuracy of the content presented, it is purely for educational purposes only and is not a substitute for professional medical advice.