Leg Ulceration

A skin ulcer is where an area of skin has broken down into an open sore. Venous leg ulcers are the commonest type of ulcer occurring just above the ankle; they usually affect older people and are more common in women. Left untreated, an ulcer may enlarge and cause problems in the leg.

A common cause of the problem is increased pressure of blood in the veins of the lower leg causing swelling, thickening and damage to the skin. The pressure in the is raised when veins have been damaged by a previous deep vein thrombosis or untreated varicose veins.

A detailed assessment that looks at possible underlying causes of the ulcer not healing is required. Mr. Morgan is able to provide a full vascular surgical examination that will guide best management of the problem.

 

Prevention

Venous leg ulcers commonly recur after they have healed, to prevent this compression stockings should be worn during daytime after the ulcer has healed.

A leg ulcer is much less likely to recur if you wear compression stockings regularly.

Treatment (if there is no arterial disease)

A venous ulcer is unlikely to heal with just dressings.

Compression bandaging is the most important part of treatment. A nurse will apply on three to four layers of tight bandages over the dressing (a compression stocking over the dressing is sometimes used as an alternative, but is not as effective as bandaging). The pressure is highest at the ankle and gradually less towards the knee and thigh.

Up to seven in ten venous ulcers heal within 12 weeks if treated with compression bandaging which is re-applied every week or so. If compression is not used the chance of healing is reduced.

A skin graft may be advised for a large ulcer, or for one that does not heal well. Surgery for varicose veins is necessary in some cases.

treating reflux

Getting an ultrasound scan of the veins in the leg will identify if there are surface veins in the leg that would benefit from treatment with laser or injections that would then help with healing of ulceration.

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