A Leg Ulcer is an area of the leg where the skin has broken down and refuses to heal. These may or may not be painful.
Leg ulcers need careful assessment as some are caused because the blood supply to the legs is poor and these are known as arterial ulcers. The commoner type are due to problems with the veins in the legs and are known as venous ulcers. Other causes can be associated with conditions such as diabetes, skin and soft tissue conditions
Venous ulcers account for 80 percent of leg ulcerations. They are difficult to treat and often occur and last many months or even years. Surgery can help, but commonly compression bandaging can help in venous ulcers.
You are more likely to develop a venous ulcer if you are older, overweight, have sustained an injury to your leg, have had a deep vein thrombosis or other venous conditions.
Venous ulcers are typically irregular and shallow and are usually located over bony prominences such as your ankle.
As we grow older the pump system which the body relies on to circulate the blood around the body breaks down and blood pools in the legs due to gravity. This causes fluid to 'ooze out' of the veins beneath the skin. This causes swelling, thickening, and damage to the skin. The damaged skin may eventually break down to form an ulcer.
Before treatment is commenced, it is important to exclude other reasons for the ulceration, a comprehensive assessment will exclude conditions such as diabetes and a special ultrasoundor taking blood pressure in the arms and legs will ensure that the problem is not caused by lack of blood supply to the legs.
- Leg elevation, compression therapy and dressings are supported by research as effective management of venous ulcers. Leg elevation reduces swelling and should be used for 30-minute sessions, 3 or 4 times a day.
- Compression therapy, which involves special bandages is the standard of care and is associated with a decreased rate of ulcer recurrence.
- Surgical Management - For ulcers that are large, of prolonged duration, or not responsive to conservative measures including pharmacotherapy, surgical management may be considered.
• Try to stop smoking if you are a smoker. The chemicals in cigarettes may interfere with the skin healing.
• Antibiotics are sometimes advised for short periods if the skin and tissues around the ulcer become infected.
• Painkillers if the ulcer is painful.
• Skin care. The skin around an ulcer is often inflamed or scaly. Your doctor or nurse will advise on creams that will reduce inflammation and keep the surrounding skin as healthy as possible.
• Dietary advice will ensure you have suitable nutrients to ensure maximum potential for healing. Also, if you are overweight then losing some weight may help.
• In The USA, they give aspirin 300mg
• Compression stockings once the ulcer has healed may prevent re-occurrence