This is particularly important if you've previously had a leg ulcer — once a leg has suffered a venous ulcer, you're at risk of further ulcers developing within months or years. Read more about preventing venous leg ulcers. Venous leg ulcers are open, often painful, sores in the skin that take more than a month to heal. A venous leg ulcer can be susceptible to bacterial infection. Symptoms of an infected leg ulcer can include:. Contact your GP if you think you've developed a venous leg ulcer.
They're unlikely to get better on their own, as they usually require specialist medical treatment. You should also contact your GP or leg ulcer specialist if you've been diagnosed with a venous leg ulcer and have symptoms that suggest it could be infected. Read more about how venous leg ulcers are treated.
A venous leg ulcer can develop after a minor injury if there's a problem with the circulation of blood in your leg veins. If this happens, pressure inside the veins increases. This constant high pressure can gradually damage the tiny blood vessels in your skin and make it fragile. As a result, your skin can easily break and form an ulcer after a knock or scratch. See your GP if you think you have a venous leg ulcer.
The ulcer is unlikely to heal without specialist treatment. Diagnosis is largely based on your symptoms and examination of your affected leg, although additional tests may be required.
Your GP or practice nurse will ask whether you have any other symptoms associated with venous leg ulcers, such as:. They'll try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as:. They'll also examine your leg, both when you're standing up and lying down.
Varicose veins will be more obvious when you're standing up, and it will be easier to look at the ulcer when you're lying down. They'll also feel your pulse at your ankles to make sure the arteries in your leg are working properly. To rule out peripheral arterial disease a condition affecting the arteries as a possible cause of your symptoms, your GP or nurse will carry out a test known as a Doppler study. This involves measuring the blood pressure in the arteries at your ankles and comparing it to the pressure in your arms.
If you have peripheral arterial disease, the blood pressure in your ankles will be lower than your arms.
It's important to carry out this check as the main treatment for venous ulcers is compression bandages or stockings to improve the vein circulation in your legs. It's not safe to apply compression if the ankle artery pressures are low. In some cases, your GP or nurse may decide to refer you to a specialist in conditions affecting the blood vessels vascular specialist.
For example, you may be referred to a vascular specialist if your GP or nurse is unsure about your diagnosis, or if they suspect your ulcer may be caused by artery diseases, diabetes or rheumatoid arthritis.
After taking your medical history and examining you, the vascular specialist may need to arrange further investigations to plan your treatment. Treatment should always be carried out by a healthcare professional trained in compression therapy for leg ulcers.
Usually, this will be a practice or district nurse. The first step is to remove any debris or dead tissue from the ulcer and apply an appropriate dressing. This provides the best conditions for the ulcer to heal. A simple, non-sticky dressing will be used to dress your ulcer.
This usually needs to be changed once a week. Many people find they can manage cleaning and dressing their own ulcer under the supervision of a nurse. To improve vein circulation in your legs and treat swelling, your nurse will apply a firm compression bandage over the affected leg.
These bandages are designed to squeeze your legs and encourage blood to flow upwards, towards your heart. There are many different types of bandage or elastic stockings used to treat venous leg ulcers, which may be made in 2, 3 or 4 different layers.
The application of a compression bandage is a skilled procedure and they should only be applied by trained healthcare staff. When compression bandages are first applied to an unhealthy ulcer, it's usually painful. Ideally, you should have paracetamol or an alternative painkiller prescribed by your GP.
The pain will lessen once the ulcer starts to heal, but this can take up to days. It's important to wear your compression bandage exactly as instructed. If you have any problems, it's usually best to contact your nurse, instead of trying to remove it yourself. If the compression bandage feels a little too tight and is uncomfortable in bed at night, getting up for a short walk will usually help.
Once you remove the bandage, make sure you keep your leg highly elevated and contact your doctor or nurse as soon as possible. In some clinics, specialist teams are using new alternatives to compression bandages, such as special stockings or other compressive devices.
These may not be available in every clinic but could change the way ulcers are treated in future. Your specialist will be able to advise you whether a different approach may help you. Venous leg ulcers are often accompanied by swelling of your feet and ankles oedema , which is caused by fluid. This can be controlled by compression bandages. Keeping your leg elevated whenever possible, ideally with your toes at the same level as your eyes, will also help ease swelling.
You should put a suitcase, sofa cushion or foam wedge under the bottom of your mattress, to help keep your legs raised while you sleep. You should also keep as active as possible and aim to continue with your normal activities.
Regular exercise, such as a daily walk, will help reduce leg swelling. However, you should avoid standing or sitting still with your feet down. If pus is draining from your ulcer, you likely have an infection. Infections are treated with antibiotics to avoid further complications. Compression bandages are also used to help ease swelling, close the wound, and prevent infection.
Your doctor may also prescribe an ointment to apply to the ulcer. In severe cases, your doctor may order orthotics or braces to help you walk better while preventing future ulcers. Pentoxifylline may be prescribed to improve the circulation in your legs. Along with medical treatment, your doctor may recommend home remedies to ease discomfort and assist in healing.
Wash the wound with mild soap and water daily. Also, change any bandages and dressings at least once daily to keep the area dry, so it can heal. Never use home or alternative methods in lieu of traditional medical treatment without checking with your doctor.
These remedies may very well be beneficial, but they can also aggravate the condition depending on the preparation and stage of your ulcers. Since poor circulation is the most common cause of leg ulcers, it makes sense to control conditions that can cause poor circulation, like:.
Staying well with a healthy diet and regular exercise can reduce your weight, thereby decreasing your risk of leg ulcers.
Decreasing your sodium intake is also important. You can do this by:. In most cases, treatment is effective in easing the symptoms of leg ulcers. In severe cases, infection can spread to the bone. Venous and arterial ulcers are open wounds that commonly occur on your lower legs and feet. Learn about how symptoms can differ and treatments for…. An ulcer is an open sore or lesion on the body that is slow to heal or keeps returning. It may be painful and could get infected.
Ulcers result from…. Ulcers are open sores that can appear on any part of the body. There are several types of ulcer. Wounds on the lower leg are often caused by problems with veins or arteries, or a combination of both. The further away from the heart, the longer wounds may take to heal, particularly in people over 50 years of age. Around one per cent of the Australian population suffers from leg ulcers chronic venous leg ulceration.
The most common cause is poor blood circulation, particularly the inability of the veins to return deoxygenated blood from the legs back to the heart. Other causes or risk factors include prolonged pressure on an area such as long-term lying in bed in one position, which may cause bed sores , badly managed diabetes, high cholesterol, smoking, dietary problems and poor arterial circulation.
Older people are at greater risk, and the number of women with leg ulcers is slightly higher than men because women have a longer lifespan. Treatment options include compression bandages, medication, surgery and more recently hyperbaric oxygen therapy. Leg ulcers, the calf muscle and poor circulation Generally, veins carry deoxygenated blood from the body to the heart, then on to the lungs.
Veins have one-way valves to prevent blood from running backwards. The contraction of muscles helps to massage blood along the veins. The calf acts as a pump, using muscular contraction in combination with deep veins and chambers to help push the blood back up through the veins.
This pumping action can be affected by a variety of problems, including blockages in the deep veins, venous insufficiency or venous disease. It is not known how poor vein circulation triggers a leg ulcer. One theory proposes that white blood cells from the immune system are trapped inside the tiny capillaries, where they then attack and destroy the nearby skin tissue.
High numbers of white blood cells and their by-products have been found in the pus of leg ulcers. Symptoms of leg ulcers Symptoms of a leg ulcer include: that they are commonly found on the lower leg and ankle a sunken, asymmetrically shaped wound the edges of the ulcer are clearly defined from the surrounding skin the surrounding skin is intact, but inflamed the surrounding skin may be pigmented, hardened or calloused yellowish-white exudate pus pain, particularly while standing varicose veins in the leg.
Varicose veins — the one-way valves that stop blood from travelling backwards in the vein stop working. The pooling of blood stretches and distorts the vein.
Cigarette smoking — tobacco is known to constrict the vessels of the circulatory system. Arterial disease — vein problems are more likely if the person already has other diseases of the arteries.
Certain disorders — these include diabetes and arthritis. Pressure sores — bed-bound people are at risk of pressure sores, which are areas of damage to the skin caused by constant pressure or friction. Medication — some cardiovascular medications can contribute to leg oedema swelling due to a build-up of fluid and altered circulation. Diagnosis of leg ulcers The doctor or specialist will take your complete medical and surgical history. They may also: examine the wound perform some tests to measure the blood flow in your lower leg, such as the ankle-brachial index.
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