The most common cause of an ulcer is poor venous circulation in the lower legs. Veins return the blood back to the heart with the aid of the calf muscle contracting which assists in pushing the blood upwards towards the heart. The valves within the veins open and close to stop the backflow of blood and these may not be working correctly due to variety of problems. The most common cause is the inability of the veins in the legs to return blood to the heart effectively. Venous legs ulcers are commonly found on the lower leg and ankle area. You may be referred to the vascular surgeon when your GP is unsure of a clear diagnosis to rule out any underlying causes.
- Painful while standing
- Sunken non symmetrically shaped wound with the edges clearly defined
- Skin surrounding the ulcer is intact but may be inflamed
- Pigmentation (red wine stain) to the surrounding skin or hardened skin surrounding the ulcer
- Itchy, red, flaky or scaly skin on your legs (varicose eczema)
- Yellowish build-up or pus within the ulcer
- Swelling in the ankles
- The ulcer may have an unpleasant discharge
Diagnosis of the ulcer
- Your surgeon will examine the wound and legs, along with a medical/ surgical history
- You may be sent for a venous ultrasound to examine the veins in one or both legs
- ABPI- blood pressure reading from your arms and ankles with a hand held Doppler or machine to rule out arterial causes.
- Ulcer swabs may be taken and sent to pathology to rule out infection
- A biopsy of the ulcer may be taken during the course of treatment
- Some ulcers will heal themselves with the assistance of suitable dressing
- Compression bandaging may be recommended to aid circulation in the venous system and healing the ulcer and these must be worn at all time during the treatment. This is the most commonly used treatment to heal venous ulcers Treatment time may take 3 – 6 months or longer to heal the ulcer and regular dressing will be done at bandage changes.
- Some ulcers may require skin grafting to assist the healing.
- Compression stocking may need to be worn when the ulcer is healed