Venous leg ulcers usually develop on the inside, sometimes on the outside of the leg, just above the ankle.
The symptoms of a venous leg ulcer include
in the affected leg. There may also be discolored or hardened skin around the ulcer, and the sore may produce a foul-smelling discharge.
Venous disease is the main reason for over two thirds of all leg ulcers. Other common types of leg ulcer include:
Most ulcers caused by artery disease or diabetes occur on the foot rather than the leg.
Venous leg ulcers are one of the most serious results of the progression of chronic venous disease; they are often chronic and difficult to heal. In fact, the recurrence rate of venous leg ulcers is more than 70 percent.
See your physician if you think you have a leg ulcer, as it will need professional treatment to help it heal. Your doctor can also help determine the type of ulcer you have and the best treatment option.
Venous leg ulcers result from progression of venous disease, notably chronic venous insufficiency (CVI).
Chronic venous insufficiency is a condition that occurs when the venous walls and/or valves in the leg veins are damaged or not working effectively.
The valves should ensure that blood flows up the leg, not down. If they are not closing properly, the blood stagnates in the veins, resulting in very high pressure in the veins when in an upright position.
This constant high pressure can gradually damage the tiny blood vessels in your skin, leading to leakage of blood into the tissue. This eventually leads to local inflammation of the tissue.
A venous leg ulcer can develop after a minor injury if there's a problem with the circulation of blood in your leg veins and a local inflammation of the tissue has started to develop.
As a result, your skin can easily break and form an ulcer after a knock or scratch.
Unless you have treatment to improve the circulation in your legs, the ulcer may not heal.
For all ulcer patients, it is recommended to take a close look at the medical history:
Your health care professional will examine your leg, both when you’re standing up and lying down.
They'll also feel your pulse at the 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 health care professional will carry out a test known as a Doppler study.
Further examinations might be done in order to assess the blood flow in your veins.
If you are diagnosed with venous leg ulcer, you are probably already working closely with a wound clinic or your physician in the management of the wound.
The primary treatment of a venous leg ulcer includes controlling any infection and healing the wound. This may take several months, depending of the size of the wound. Managing pain and minimizing the oedema as well as protecting the healthy skin are important.
Compression helps to improve vein circulation in your legs and to treat swelling. It plays an important role in the healing of your wound and in post-wound care.
Traditionally, short-stretch compression bandages are used in the initial phase of treatment of large ulcers until healing is nearly complete or the patient can be fitted in a knee-length graduated compression stocking at 30–40 mmHg or higher.
Also, compression stocking systems are available. They consist of a normal compression stocking and a patented low-compression understocking. These systems offer many benefits above and beyond those of bandages:
With appropriate treatment, most venous leg ulcers heal within 3 to 4 months.
Once your wound is healed, you should continue wearing your compression stockings for life to prevent development of another ulcer.