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venous ulcer treatment
Venous ulcers, also known as venous stasis ulcers, are open wounds that develop on the lower legs due to poor circulation of blood in the veins. They are often a result of chronic venous insufficiency, where the veins fail to efficiently return blood to the heart, causing blood to pool in the legs.
Treatment for venous ulcers aims to promote healing, prevent infection, and address the underlying causes of poor circulation. Here are some common approaches to venous ulcer treatment:
- Compression Therapy: This is a cornerstone of venous ulcer treatment. Compression stockings or bandages are used to apply pressure to the legs, helping to improve blood flow and reduce swelling.
- Wound Care: Proper wound care is essential for venous ulcers. This includes cleaning the wound, removing dead tissue (debridement), and applying dressings to promote healing.
- Elevation: Elevating the legs above heart level when resting can help reduce swelling and improve blood flow.
- Exercise: Regular physical activity, especially exercises that work the calf muscles, can improve circulation and help prevent ulcers from recurring.
- Medications: Topical or oral medications may be prescribed to manage pain, prevent infection, or improve circulation.
- Lifestyle Changes: Quitting smoking, maintaining a healthy weight, and managing conditions like diabetes and high blood pressure can all contribute to better overall vascular health.
- Vascular Interventions: In some cases, procedures like vein ablation or sclerotherapy may be recommended to treat underlying vein issues and prevent ulcer recurrence.
It’s important for individuals with venous ulcers to work closely with healthcare professionals, such as vascular specialists or wound care experts, to develop a comprehensive treatment plan tailored to their specific needs. Regular monitoring and follow-up care are also crucial for successful ulcer management.
What is a leg ulcer?
A leg ulcer is simply a break in the skin of the leg, which allows air and bacteria to get into the underlying tissue. This is usually caused by an injury, often a minor one that breaks the skin.
In most people such an injury will heal up without difficulty within a week or two. However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size. This is a chronic leg ulcer.
What causes leg ulcers?
The most common underlying problem causing chronic leg ulcers is disease of the veins of the leg. Venous disease is the main reason for over two thirds of all leg ulcers.
- Venous Disease (caused by veins not working) – about 80% of leg ulcers
- Arterial Disease (caused by the arteries not working) – about 15% of leg ulcers
- Other causes (includes diabetes and rheumatoid arthritis as well as some rare conditions) – about 5% of leg ulcers
In some cases two or more conditions may be causing damage at the same time. Your doctor will examine you and do some tests to see what sort of ulcer you have. The following advice applies to venous ulcers and may not be appropriate for other sorts of ulcers.
How does venous disease cause ulcers?
The veins in your leg are tubes that carry the blood back from the foot towards your heart. The veins in your legs have one-way valves that make sure the blood flows up the leg and not back down. In some people, these valves are not very effective or can be damaged by thrombosis (clots) in the veins. If the valves are damaged, blood can flow the wrong way down the veins, which results in a very high pressure in the veins when standing up. This abnormally high pressure in the veins damages the skin and leads to the ulcers.
Who’s affected?
Venous leg ulcers are estimated to affect around 1 in 500 people in the UK, although they become much more common with age. It’s estimated that around 1 in 50 people over the age of 80 has one.
You’re more at risk of developing one if you’ve previously had deep vein thrombosis (DVT) or find it difficult to walk because of a problem such as:
- osteoarthritis
- a leg injury
- obesity
- paralysis
WHAT ARE THE SYMPTOMS OF LEG ULCERS?
The symptoms of leg ulcers can differ depending on the root cause of the ulcers. In most cases, ulcers are painful, however, in some instances where ulcers cause little or no pain, they are usually due to nerve damage from mismanaged diabetes or leprosy. Moreover, the absence of pain is one reason why many individuals do not seek the required medical treatment. It is vital to make an appointment with the doctor if a person experiences any of the following symptoms:
- Swollen ankles
- Discolouration or staining on the skin
- Generalized pain or heaviness in the leg
- Hardened skin and pus in and around the affected are
- Increasing wound size
- Enlarged veins
- Leg swelling
CAUSES OF LEG ULCERS
- Venous Diseases : Most of ulcers develop around the ankles when the veins stop working . Venous diseases are triggered when the valves present inside the are damaged. The function of leg valves is to ensure that the blood flows up towards the heart while circulating the body. However, if the are defective, they are unable to stop blood the flow of blood back into the legs. that can ultimately cause the to become inflamed and thin, which eventually breaks down into ulcers.
- Arterial Diseases : Arterial disease ulcers are generally multiple and painful due to oxygen supply from poor circulation in arterial disease. Arterial are known leg ulcers. This occurs when there is a blockage in at least one of the arteries present in the leg which stops the blood . Smoking is a factor in arterial disease of the legs.
- Underlying Conditions : Certain leg ulcers happen because of underlying ailments such as rheumatoid arthritis, diabetes, leprosy or some other neurological disease. However, in some cases, multiple conditions may also contribute to the development of leg ulcers.
WHAT ARE THE TYPES OF LEG ULCERS?
The three most common types of leg ulcers include:
- Venous Stasis Ulcers : These are common in individuals who have a history of varicose veins, leg swelling, or blood clots in either the deep or superficial veins of the legs.
- Neuropathic Ulcers(diabetic) : These occur mainly in individuals who have diabetes. However, it can also affect people suffering from impaired sensations in the feet due to neurological disorders.
- Arterial (ischemic ulcers) : An individual with cardiac or cerebrovascular diseases is likely to suffer from arterial ischemic ulcers.
WHAT ARE THE TREATMENT OPTIONS FOR LEG ULCERS?
Some of the most common treatment options for leg ulcers include:
- Compression Bandaging : This is the most vital part of a leg ulcer treatment. It is done to counteract the raised pressure in the leg veins. This treatment method gives the most significant chance for the ulcer to heal.
- Skin Graft : This may be advised for a large-sized ulcer, or for an ulcer that does not heal well.
- Surgery : This is advised for varicose veins or other vein problems in some cases. This helps in correcting the back pressure of blood pooling in the veins and let an ulcer to heal.
- Skin Care : The skin around an ulcer is often scaly or inflamed. The doctor or specialist may advise the patient to use an ointment or cream to reduce inflammation. Wound care and regular dressing play a major factor in the healing of the ulcer.
- Dietary Advice : Obesity is a risk factor for developing venous leg ulcers. If a patient is overweight, then losing weight helps in healing the ulcer. During the healing process, the body needs increased amounts of vitamins A and C, proteins, calories, and sometimes even mineral zinc.
FOLLOW UP CARE AFTER LEG ULCERS TREATMENT