Venous Ulcers

Ulcers are wounds which are not caused due to external injury rather caused as a complication of any persisting condition or disease. Pathology is complex and multifactorial, involves genetic, physiological, environmental, hormones, cellular, endothelial dysfunction, chronic inflammation and vein wall defects etc., contributes either predisposing or accelerating or contributing for venous ulcers. One of the major cause is due to pool/ stagnation of blood in veins due to their improper function. Venous causes contribute ~ 70-90% of chronic leg ulcers, typically ulcer is seen in medial part of distal legs and most likely recurrent in nature.   

  • Chronic venous insufficiency
  • Varicose vein
  • Deep vein thrombosis
  • Heart failure
  • Leg muscle weakness
  • Stasis dermatitis – Scaling and erythema in legs
  • Brownish or yellow patches or dark red or purple colour beneath skin
  • Large and irregular margined ulcer below knee
  • Red coloured with exudates
  • Pain less but painful in presence of infection or edema
  • Stasis dermatitis
  • Foot elevation reduces swelling and discomfort


  • Physical examination:









Medial malleoli ( ankle)  to mid-calf

Distal leg -Dorsum of foot or toes

Over pressure points



Shallow, irregular border with moist granulation base. Yellowish exudate

Grayish, unhealthy, granulation tissue

Punched out with a deep sinus, surrounded by chronic inflammatory tissue



Oozes venous blood

Bleed very littler or not at all

Brisk bleeding



Mild pain reduces by elevation

Especially at night in supine position

Pan less


On examination

Signs of stasis dermatitis

Hair loss around, pale skin and absent pulse

Hypesthesia  and reduced sense

  • Ankle-Brachial Index to look for involvement of blood supply from arteries
  • Doppler ultrasonography
  • Venography



  • Venous eczema
  • Cellulitis
  • Osteomyelitis and Septicemia
  • Chronic ulcers and non-healing ulcers leads to much higher risk of amputation
  • Cancer  

Current treatment:

  • For venous ulcers
  • Compression therapy
  • Wound managements
  • Wound cleaning and dressing
  • With or without antibiotics
  • Skin grafting, if large wound or painful
  • Amputation


Our treatments: Various research articles and we believe that

  • Wound management:
  • Fortified Gomutra Arkais used for cleaning the wound helps in
    • Remove moist granulation and debris by its scraping nature
    • Reduce infection by antimicrobial property
    • Reduce oxidative stress by antioxidant effect facilitates cell function
    • Significantly increased wound contraction/ reduction
  • Yoga: A blend of customised Asana (yoga postures) and Pranayama (Regulated breathing technique) are advised depending on individual need as per their Prakruthi (body type) and comorbidities.


  • Our medicine:
  • Improves circulation and reduce swelling
  • Antioxidant reduces oxidative stress to make cells to function effectively
  • Reduce infection as it is the major factor associated with worse prognosis during follow-up
  • Improves microenvironment, re-activate signalling pathways that work to restore the tissue environment consisting of cell and extracellular matrix with enzymes, cytokines and growth factors
  • Promotes Angiogenesis i.e., formation of new blood vessels from pre-existing vasculature which is prominent feature of proliferative phase to rebuild new tissue and wound contracts to heal the wound.