Chronic venous insufficiency and venous leg ulcers: compression, elevation and leg care
- Safe practice
Venous ulcers heal with compression, raising the legs, walking and skin care; the nurse checks arterial flow first and watches for infection.
What it is
In chronic venous insufficiency, blood pools in the leg veins, the leg swells and the skin of the lower leg becomes fragile and an ulcer can open. Healing rests on compression, which the nurse applies only after the arterial circulation has been checked, raising the legs above the heart, daily walking, keeping the wound clean and covered, and moisturising the surrounding skin. The nurse measures and documents the ulcer, watches for infection and teaches the patient to continue care at home. The technique of compression bandaging is on its own page.
What it requires
- Assessing the ulcer: site, size, depth, bed, edges, drainage and surrounding skin, recorded the same way each time.
- Checking the arterial circulation before compression.
- Compression, elevation and walking as the treatment plan sets.
- Skin care of the whole lower leg.
- Teaching the patient and family to continue at home.
How it is applied (and why)
- Measure and describe the ulcer and the skin around it the same way each time — shows whether it is healing.
- Compare pulses, colour and warmth of the feet before compression — compression on poor arterial flow causes ischaemia.
- Apply the compression ordered with the technique on the compression page, smooth and without wrinkles — even pressure helps return.
- Raise the legs above the heart at rest and avoid long standing or sitting with legs down — less swelling.
- Encourage daily walking and ankle movement — the calf pump moves venous blood.
- Clean and dress the ulcer as the plan sets and keep the dressing dry — reduces infection.
- Moisturise the intact skin of the lower leg and protect it from injury — the skin is fragile.
- Teach how to put on and care for stockings and the infection signs — healing continues at home.
In nursing practice
- Call for redness, warmth or swelling around the wound, more or yellow or cloudy drainage, bleeding or odour.
- Call for fever, chills or pain that increases.
- Call if the toes become pale, blue, cold or numb under compression; loosen as the protocol says.
- Report an ulcer that does not improve as expected: the plan may need a review.
- Look for leg wounds also in patients with a history of DVT or varicose veins.
Common mistakes
- Applying compression without checking arterial flow.
- Letting stockings wrinkle or roll down into a tight band.
- Measuring the ulcer differently each time, so progress cannot be judged.
- Neglecting the skin around the ulcer.
- Advising rest in bed without leg elevation instead of walking.
Test yourself
Think of the answer, then tap the question to see it.
Why is arterial circulation checked before compression?
Because compression on a leg with poor arterial flow can cut off its blood supply and cause ischaemia.
How should the legs be positioned at rest in venous insufficiency?
Raised above the level of the heart, for example lying with the feet on pillows, as often as possible.
Why is daily walking encouraged?
Because the calf muscle pump pushes venous blood back up the leg, which reduces swelling and helps healing.
Which signs suggest infection of a venous ulcer?
More redness, warmth or swelling, more or cloudy drainage, odour, bleeding, fever or chills, or increasing pain.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Venous ulcers - self-care: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026); Nursing Skills, 9.3 Cardiovascular Assessment (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); Deep vein thrombosis - discharge: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026).
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Representative model, for educational purposes only.