“An ounce of prevention is worth a pound of cure” is a wise old saying that we’ve all grown up hearing. Hence, simple steps taken to prevent the onset of venous ulcers can go a long way in saving you from the morbidity caused by it and also the massive cost incurred in treating it.
Lifestyle modifications are the first and the foremost measures to be taken. These include –
1) Quit smoking – Research has shown that lower limb venous insufficiency is significantly associated with tobacco smoking. Tobacco has deleterious effects on the structure of blood vessels and is also known to cause delay in wound healing.
2) Control of chronic conditions – The role of diabetes mellitus and hypertension in causing vascular and cardiac complications is well established. Hence, there is an imperative need to constantly monitor sugar and blood pressure levels and have a good control over them.
3) Lose weight – Reducing body fat and maintaining it within a desirable range will help take unwanted pressure off the lower limbs. It also promotes overall health and well being.
4) Regular exercise – Exercise aids in the process of weight loss. Incorporating some form of physical activity will also cause activation and contraction of leg muscles. This in turn will help in pushing the blood towards the heart and avoiding it’s stasis in the legs, which otherwise would’ve eventually lead to the formation of ulcers. Taking just a simple walk around the neighborhood could prove to be highly beneficial.
5) Healthy diet – Adopting a healthy, balanced diet will keep a check on the body weight as well as will help in preserving the general health and fitness status.
The whole mechanism behind the formation of venous ulcers is based on the fact that pooling of blood occurs in the veins of lower limbs. This further leads to the ulceration of the overlying skin. Therefore, driving the blood forward and improving circulation in this region acts as a very powerful precautionary tool in preventing the onset of venous ulcers. This can be achieved by the following methods.
Preventive Methods for Varicose Veins:
1) Compression stockings – These are specially designed hosiery which help compress the superficial veins of legs, thereby squeezing the blood contained in it. They’re usually tightest at the ankle and tend to loosen up as you move up the leg which encourages blood to be driven upwards, towards the heart. It controls overdistention of the veins, reduces the tension on its walls and prevents backflow of blood. This results in the improvement of odema, promotes ulcer healing and its use is highly recommended.
2) Avoid standing or sitting (particularly cross legged) for long periods of time. It is desirable to take breaks in between.
3) Elevation of the affected limb to a level higher than the level of the heart will ease the flow of blood towards the heart. Place the legs over a tall stool while sitting or over a stack of pillows while lying down for about half an hour, at least 3-4 times a day.
4) Take a walk around as often as you can. This will cause the contraction of calf muscles, thereby moving the blood collected within it towards the heart.
5) Avoid the use of heels. These kind of footwear do not allow the calf muscles to work properly, hence hampering their ability to aid with the circulation. Use flat, comfortable footwear instead.
6) Supplementation of phlebotonic drugs like Daflon in conjunction with compression therapy is desirable. These drugs increase the firmness of the venous wall, helping it to resist over-distention due to any reflux along it’s course. Prophylactic aspirin may also be started in selected individuals to prevent the formation of clots (leading to DVT).
7) Treatment of underlying venous disorders like varicose veins is absolutely crucial in order to encourage ulcer healing and prevent its recurrence. Therapeutic options include both surgerical and other minimally invasive procedures like endovenous laser ablation, radiofrequency ablation and sclerotherapy among others. An appropriate approach is chosen based on the severity of the condition and the patient’s needs and preferences.