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Stasis ulcer
Other Resources UpToDate PubMed

Stasis ulcer

Contributors: Jeffrey M. Cohen MD, Susan Burgin MD
Other Resources UpToDate PubMed


Stasis ulcers, or venous ulcers, are ulcers due to venous insufficiency. They are large, irregularly shaped, shallow ulcers that often demonstrate a yellow exudate covering the wound bed. They are most commonly found in the medial malleolar region of the lower extremity. While the reported prevalence varies, it is estimated that approximately 0.05%-1.52% of Americans suffer from venous ulcers. An increased prevalence is seen with age, and both sexes are affected equally. Additional risk factors include a history of thrombosis, phlebitis, leg injury such as fracture or trauma, pregnancy, obesity, lower socioeconomic status, and social isolation.

The primary pathophysiology involves incompetent one-way venous valves or dysfunctional calf muscle pumping, leading to insufficient venous blood return to the heart and chronic leg venous hypertension. This venous hypertension leads to aberrant tissue perfusion and subsequent decreased delivery of oxygen and nutrients, failure to remove metabolic byproducts, and tissue ischemia.

Additional clinical features commonly associated include leg and ankle edema, varicose veins, yellow-brown pigmentation secondary to hemosiderin deposition and extravasated red blood cells, eczematous changes with scaling and crusting (stasis dermatitis), and lymphedema. Lipodermatosclerosis is also seen and corresponds to fibrotic changes in subcutaneous tissue leading to a hard and indurated feel to the skin. An "inverted champagne bottle" leg indicates end stage lipodermatosclerosis and is caused by severe fibrotic changes in the distal leg and leg edema of the proximal leg. Atrophie blanche are smooth, ivory-colored atrophic plaques secondary to sclerosis seen in approximately 40% of patients with venous insufficiency.

Additional key points are that stasis ulcers usually begin on the medial malleolus but may become circumferential over time. They may be painful, are difficult to treat, and frequently recur. They may become secondarily infected.


I83.009 – Varicose veins of unspecified lower extremity with ulcer of unspecified site

41915009 – Stasis ulcer

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Last Reviewed:09/11/2018
Last Updated:02/12/2019
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Patient Information for Stasis ulcer
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Contributors: Medical staff writer


A stasis ulcer is a breakdown of the skin (ulcer) caused by fluid build-up in the skin from poor vein function (venous insufficiency). Fluid leaks from the veins into skin tissue when the blood backs up rather than returning to the heart through the veins.

Who’s At Risk

Leg vein malfunction (venous insufficiency) affects 2-5% of Americans, and approximately half a million Americans have stasis ulcers. Women are more often affected by stasis ulcers than men.

Your risk for acquiring a stasis ulcer is greater if you:
  • Are overweight.
  • Have varicose veins.
  • Have had blood clots in your legs.
  • Had a leg injury (trauma) that might affect blood flow in your leg veins; even minor trauma may cause an ulcer.

Signs & Symptoms

Swelling of the leg, brown discoloration, or an itchy, red, rough area (stasis dermatitis) may appear before you notice an ulcer. This is often seen on the inner ankle area first, although any area on the lower leg may be affected. Varicose veins may be present. Sometimes there are hard, tender lumps under the skin near the ulcer.

The ulcer is a crater-like, irregular area of skin loss. It may be an open, easily bleeding, painful wound, or it might have a thick black scab. The level of pain varies.

Self-Care Guidelines

People with a leg ulcer should seek medical care if it is anything beyond a small scrape or cut on the surface of the skin.

If the ulcer appears minor:
  • Clean it with soap and water.
  • Apply a thin layer of petroleum jelly (Vaseline) and a clean gauze bandage.
  • Avoid putting any tape or adhesive on the skin.
  • Avoid using topical antibiotics and other over-the-counter products, as people with leg ulcers often become allergic to these products.

When to Seek Medical Care

If you have pain, swelling, spreading red areas, fever, or any open wound that does not heal after a few days of self-care, seek medical advice.


In addition to a thorough exam, your physician may test to evaluate how well your veins are working.

Treatment may consist of:
  • Procedures to reduce leg swelling.
  • Medication for any dermatitis or infection that is present.
  • Special wound dressings.
  • Pentoxifylline to aid healing.
  • Surgery if other medical treatment fails.
  • Compression hose to prevent the ulcer from coming back.
Most ulcers heal within 1-4 months, but about 25% will still be present after a year.


Bolognia, Jean L., ed. Dermatology, pp.1635. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. pp.21. New York: McGraw-Hill, 2003.
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Stasis ulcer
A medical illustration showing key findings of Stasis ulcer : Erythema, Irregular configuration, Leg, Skin erosion, Skin ulcer, Peripheral leg edema
Clinical image of Stasis ulcer - imageId=210935. Click to open in gallery.  caption: 'Numerous ulcers of varying sizes with yellow slough at their bases and surrounding erythema on the leg.'
Numerous ulcers of varying sizes with yellow slough at their bases and surrounding erythema on the leg.
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