Leg ulcers​

Getting to Know Leg Ulcers: Causes, Types, Symptoms, and Management

Leg ulcers, persistent sores below the knees that haven’t healed in six weeks, often stem from poor blood circulation in the legs. Understanding the intricacies of this condition can help individuals seek appropriate medical attention and adopt effective management strategies for prompt healing.

Delving into the Origins: Causes of Leg Ulcers

Impaired blood vessel function in the legs predominantly triggers leg ulcers. Depending on the specific vessels affected, these ulcers can be classified as venous, arterial, or mixed. Additionally, other factors like diabetes, certain inflammatory diseases, and skin tumors can contribute to leg ulcers.

Exploring Venous Leg Ulcers

Among the most common type, venous leg ulcers result from inadequate blood flow in the veins, referred to as venous insufficiency. Veins transport blood from various body parts back to the heart. When vein function deteriorates, blood pools in the feet and lower legs, causing swelling. This prolonged swelling can lead to eczema and the formation of sores.

Contributing Factors to Venous Ulcers

  • Age-related natural vein function decline.
  • Overweight or obesity.
  • Lack of physical activity.
  • Blood clots.
  • Hereditary factors.

Understanding Arterial Leg Ulcers

Following venous ulcers, arterial ulcers are the second most common type. Arterial leg ulcers arise from poor blood flow in the arteries, referred to as arterial insufficiency. Arteries carry blood from the heart to the body. When arteries become narrow and rigid, blood flow becomes challenging, especially to the feet and lower legs. Inadequate oxygen and nutrition supply to these areas leads to thin and brittle skin, making wounds more prone to formation and challenging to heal.

Risk Factors for Arterial Ulcers

  • Atherosclerosis, where arteries narrow and stiffen due to fat deposits.
  • High blood pressure.
  • Smoking.
  • Diabetes.
  • Obesity.

Mixed Ulcers: The Combination of Venous and Arterial Insufficiency

Some leg ulcers are a combination of both venous and arterial insufficiency, known as mixed ulcers.

Spotlight on Symptoms

Symptoms of leg ulcers vary based on the type:

Venous Leg Ulcers:

  • Sores near ankles or shins.
  • Superficial and irregularly shaped wounds.
  • Heaviness in legs and feet.
  • Dull pain or heaviness exacerbated when standing.
  • Swollen feet and lower legs.

Arterial Leg Ulcers:

  • Sores on toes, heel, back of the foot, or ankles.
  • Well-defined and relatively deep wounds.
  • Cold, pale skin around the wound, sometimes with a black scab.
  • Severe pain, especially during walking or lying down.

Empowering Preventive Actions

  • Regular exercise to enhance leg muscle strength and blood flow.
  • Quit smoking to improve blood circulation.
  • For diabetes patients, maintain normal blood sugar levels through proper treatment.
  • Wear support stockings if prone to leg swelling.

Management Approaches

Venous Leg Ulcers:

  • Wound dressing to maintain moist wound environment for better healing.
  • Compression to reduce swelling and enhance blood flow.
  • Pain relief through over-the-counter or prescription painkillers.
  • Varicose vein surgery to prevent further ulcers.
  • Skin transplantation in severe cases.

Arterial Leg Ulcers:

  • Wound dressing for clean, dry wounds to prevent infection.
  • Pain relief with over-the-counter or prescription painkillers.
  • Treat underlying conditions contributing to arterial insufficiency.
  • Arterial surgery to improve blood flow.

When to Seek Medical Attention

Medical attention is necessary if:

  • Sores on legs haven’t healed in six weeks.
  • Angina in legs with new leg or foot sores.
  • Diabetes patients develop sores on feet or lower legs, regardless of pain.
  • Ulcers become infected, emit foul odor, intensify pain, or exhibit redness, swelling, or warmth around the wound.