When flying this summer, beware of blood clots and leg ulcers

Apr 23 2005

Although recent news coverage has linked long-distance air travel with the dangers of blood clots, few people have realized the increased risk for leg ulcers, as well.

“Once a person develops a blood clot in the leg, the valves in the veins may be damaged, putting the person at high risk for developing leg ulcers,” said Gerit Mulder, DPM, director of the University of California, San Diego (UCSD) Medical Center Wound Treatment and Research Center. “A leg ulcer may not develop for many years after the damage to the veins has occurred.”

Blood clots, also called deep-vein thromboses (DVT), can result from extended periods of immobility. At risk are those individuals on long flights, those who fly frequently, and individuals with a family history of such problems.

Noting that there are many theories as to why leg ulcers develop after blood clots, Mulder explained that the deep veins have a system of one-way valves that ensure correct directional blood flow. When the valves are damaged from trauma, as may occur with a blood clot, the blood flow may be affected, resulting in backflow and pooling of blood in the legs. Over the years, this can lead to skin changes and ulcers, which are breaks in the outer layers of the skin that fail to heal.

The prevalence of circulatory problems related to the lower extremity veins in the adult population is about 1-2 percent, with many of these individuals having venous leg ulcers, similar to those that can develop after blood clots. It is estimated that as many as 800,000 people a year with vein problems, develop ulcers. Despite their prevalence, leg ulcers are often neglected or managed inadequately.

“The mainstay of treatment for venous leg ulcers is compression therapy,” Mulder said. “Those with a history of venous leg ulcers should wear compression stockings for the rest of their life, even after the wound is healed.”

He added that different types of dressings may also be used with the compression. Surgery may be considered necessary in some cases. “The response to treatment may vary depending on the extent of vein damage, the patient’s medical status, and the ability to tolerate compression.”