What Is a Venous Leg Ulcer?
A venous leg ulcer is an open sore on the lower leg, usually around the ankle, caused by poor blood flow in the veins. When the valves in the veins fail, blood pools in the lower leg. This increases pressure, damages the skin, and eventually leads to ulcer formation.
Most patients who develop venous ulcers also have:
- Varicose veins
- Chronic venous insufficiency
- Leg swelling (oedema)
- Skin changes around the ankle
- Past history of deep vein thrombosis (DVT)
Symptoms of Venous Leg Ulcers
Many patients initially ignore early signs until the wound breaks open. Recognizing early symptoms helps prevent complications.
- A wound or open sore near the ankle
- Dark or brownish skin around the ankle (haemosiderin staining)
- Leg swelling that worsens throughout the day
- Skin dryness, itchiness or hardening
- A shallow wound with irregular edges
- Fluid leakage from the wound (“weeping”)
- Pain or discomfort when walking or standing
If your wound has not improved after 2 weeks, you should seek vascular assessment.
What Causes Venous Leg Ulcers?
The underlying cause is venous reflux—a condition where vein valves fail to pump blood back to the heart.
This causes:
- High venous pressure
- Pooling of blood
- Skin breakdown
- Tissue damage
- Chronic inflammation
Over time, even a small scratch or insect bite can turn into a non-healing ulcer.
Other risk factors include:
- Varicose veins
- Family history of venous insufficiency
- Prolonged standing or sitting
- Obesity
- Older age
- Previous leg injuries
- Diabetes
- Smoking
How Is a Venous Leg Ulcer Diagnosed?
A proper diagnosis requires a venous duplex ultrasound scan to assess blood flow. This scan identifies:
- Reflux in superficial veins
- Deep vein incompetence
- Blockages or past clots
- Which veins require treatment
Treatment Options for Venous Leg Ulcers in Singapore
Treating only the surface wound will not achieve long-term healing. Successful treatment must address both the wound and the underlying venous disease.
Below are the most effective treatment options.
1. Advanced Wound Care
Your wound specialist may use a combination of:
- Medical dressings
- Antibacterial or biofilm-targeted dressings
- Debridement (removal of dead tissue)
- Moisture-balancing wound products
- Negative pressure therapy (for selected cases)
- Electrical stimulation ultrasound therapy (CUSEFS)
- Ultrasound wound therapy
These techniques improve tissue oxygenation and speed healing. Learn more about our advanced wound care services.
2. Compression Therapy
Compression is the cornerstone of venous ulcer treatment. It reduces swelling and helps blood move upward.
- Multilayer compression bandaging
- Compression stockings (20–30 mmHg or 30–40 mmHg)
- Velcro compression wraps for convenience
Most ulcers heal significantly faster when compression is used consistently. Read more about compression therapy.
3. Treating Varicose Veins and Venous Reflux
To prevent recurrence, venous insufficiency must be corrected.
- Radiofrequency Ablation (RFA)
- Pahrmaco mechanical sclero ablatyion
- VenaSeal Glue Closure
- Foam sclerotherapy
- Ultrasound-guided Foam sclerotherapy
These are minimally invasive, clinic-based procedures with fast recovery. Visit our page on varicose vein treatment for more details.
4. Lifestyle Modifications
To improve venous circulation:
- Elevate your legs when resting
- Regular walking
- Avoid prolonged standing or sitting
- Maintain a healthy weight
- Stop smoking
- Wear compression stockings daily
These habits support long-term healing.
5. When Surgery Is Needed
Surgery may be considered when:
- There is severe skin damage
- Ulcers recur frequently
- Venous reflux is extensive
- There is an infection or abscess formation
Vascular surgeons assess each case individually.
How Long Does It Take for Venous Leg Ulcers to Heal?
Healing time depends on:
- Severity of ulcer
- Presence of infection
- Amount of swelling
- Whether venous reflux is treated
- Patient’s medical conditions (e.g., diabetes)
- Adherence to compression therapy
Most venous ulcers heal within 4–12 weeks with proper treatment. However, untreated reflux can cause repeated recurrence.
Are Venous Leg Ulcers Dangerous?
Yes, if untreated, ulcers can lead to:
- Infection
- Cellulitis
- Chronic pain
- Discharge and foul odour
- Deep tissue infection
- Reduced mobility
- Recurrent ulcers
Early treatment prevents these complications.
Cost of Venous Leg Ulcer Treatment in Singapore
Costs vary depending on the treatment needed:
- Initial consultation: $150–$250
- Venous duplex for varicose veins: ~$600/ leg
- Wound dressing session: $100–$200 per session
- Compression therapy: $80
- In-clinic foam sclerotherapy/microsclerotherapy: ~$1000-1200 per session
- Inpatient treatment of Varicose veins (MOH Fee Benchmarks)
TOSP Code Table Treatment Fee Guide SD713B 3B Vein, Varicose Veins, Imaging Guided Endovenous Laser/ Radiofrequency Treatment, 1 Leg $4900-$7300 SD714B 4A Vein, Varicose Veins, Imaging Guided Endovenous Laser/ Radiofrequency Treatment, 2 Leg $6700-$10100 SD808V 3B Ligation and Removal of Superficial Visible Varicose Veins $2600-$4300 SD717V 3B Imaging Guided Foam Sclerotherapy and Pharmaco Mechanical Sclero Ablation $1900-$4300
The surgical fees at The Vascular Vein and Wound Centre are in line with the MOH Fee Benchmarks. Please note that the quoted fee excludes consumables, hospital accommodation, and hospital facility charges.
MediSave and Medishield Life will cover part of the cost, depending on the treatment type and policy.
How to Prevent Venous Leg Ulcers
Prevention is crucial because venous ulcers may recur.
- Wearing daily compression stockings
- Treating varicose veins early
- Keeping active
- Maintaining ideal body weight
- Avoiding long periods of sitting
- Managing diabetes and hypertension
- Regular follow-up with a vascular specialist
When Should You See a Vascular Specialist?
Seek medical attention if:
- Your leg wound is not healing after 2 weeks
- There is increasing redness, pain or pus
- Your wound keeps recurring
- You have leg swelling with skin discolouration
- You have varicose veins with skin changes
Early treatment ensures faster healing and fewer complications.
Why Choose The Vascular Vein and Wound Centre
At The Vascular Vein and Wound Centre, we provide comprehensive care for venous ulcers:
- In-clinic venous duplex scans
- Full range of minimally invasive varicose vein treatments
- Advanced wound care equipment
- Experienced vascular and endovascular specialist
- Personalised compression therapy
- Convenient location at Farrer Park Medical Centre
Our goal is to help patients recover faster and reduce recurrence.
Frequently Asked Questions (FAQ)
1. Can venous leg ulcers heal on their own?
They rarely heal without proper compression and treatment of venous reflux.
2. Are venous ulcers the same as diabetic foot ulcers?
No. Venous ulcers usually occur near the ankle, while diabetic ulcers often occur on the foot.
3. Do I need surgery to treat a venous ulcer?
Not always. Many patients heal with wound care and compression. But treating reflux improves long-term outcomes.
4. Is compression painful?
It should not be painful. Properly fitted compression reduces discomfort and swelling.
