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Venous ulcers, the most common type of chronic lower extremity ulcers, can be painful and debilitating for patients. Reoccurrence rates are high: More than 90% of patients with a venous leg ulcer will experience one recurrence, and one-third will experience four or more over their lifetimes. Venous ulcers are also associated with devastatingly high healthcare costs.
The Economic Toll of Venous Ulcers
There has been a steady increase in the costs associated with these non-healing wounds. In 2009, the total costs to treat ulcers was estimated to be upwards of $3.5 billion. By 2014, just five years later, that burden was estimated at $14.9 billion.
The annual per-patient cost to treat a venous ulcer is estimated at $10,563, according to a study published in the Journal of Vascular Surgery. When it’s a chronic, nonhealing ulcer, the cost rises to nearly $34,000 or more than $2,800 per venous ulcer patient per month. The Journal of Vascular Surgery study found that when venous ulcers were treated with surgical intervention, costs rose to $19,503, but recurrence rates dropped from an average of 34% to just 5%.
In addition to the direct costs, chronic venous ulcers burden economic productivity by resulting in the loss of 4.6 million work days per year. There are also outpatient and inpatient facility costs as well as those that cover visiting nurse services and dressing supplies.
Venous Ulcers: Who’s at Risk?
Venous ulcers most often occur in patients over age 55 as well as in patients with family history of chronic venous insufficiency. Other risk factors include higher body mass index, history of pulmonary embolism or superficial/deep venous thrombosis, lower extremity skeletal or joint disease, higher number of pregnancies, parental history of ankle ulcers, physical inactivity, history of ulcers, severe lipodermatosclerosis and venous reflux in deep veins.
These ulcers most often affect the lower extremities, particularly near the ankle bone. If they persist more than three months, are larger than 3.9 inches, or the patient has lower limb arterial disease, advanced age, and elevated body mass index, a poor prognosis is expected.
Social and Psychological Impacts
Patients who do develop venous ulcers may suffer social and psychological effects in addition to physical symptoms. For example, a venous leg ulcer that’s oozing fluid and odors might cause a patient to avoid social situations that can lead to embarrassment.
Pain and difficulty getting around may also keep patients isolated, which negatively affects their wellbeing. Compression bandaging and changes in footwear might also impact a patient’s appearance, which could negatively affect their body image. But if they choose to stop those treatment options, their physical symptoms will only deteriorate.
Decrease Risk of Venous Ulcers
When a patient develops a venous ulcer, it can be painful, inhibit mobility and negatively affect their quality of life. Even with treatment, there is a high rate of recurrence, especially if the underlying condition is left untreated. To decrease risk for developing venous ulcers, patients can adopt the following habits in order to ensure good blood flow in their legs, according to Johns Hopkins Medicine:
- Avoid smoking
- Lose weight if you’re overweight or obese
- Stay at your ideal weight
- Get plenty of regular exercise
- Move around often
- Raise (elevate) your legs for a short time, especially if you’ve been standing all day
- Wear compression stockings