What are venous leg ulcers?

A venous leg ulcer is one of the most common types of leg sore. Usually, it develops after any minor injury or venous disease.

Venous leg ulcers refer to an open sore that develops in the lower leg or ankle skin. It took a long time to heal, these ulcers are long-lasting, and they can last for a few weeks to years. 

Venous leg ulcers took a lot of time to heal because of poor blood circulation in the limb. 

This ulcer discolours the affected area and makes the skin hardens around the ulcer. The open lesion may also produce a discharge with a foul smell. 

People over the age of 65, have more chances of developing venous leg ulcer.

If venous leg ulcers are left untreated, it can develop into more severe issues.

Symptoms of venous leg ulcers

Symptoms of leg ulcers may vary according to the exact cause of the ulcer.

Here are the symptoms:

  • Open sores
  • Pain in the affected area
  • Itchiness around the sore
  • Burning sensation
  • Developing rash or dry skin
  • Increasing the size of the sore
  • Swelling leg
  • Swollen ankles (edema)
  • Enlarged veins
  • Heaviness in the leg
  •  Discolouration and darkening around the lesion
  • Aching 
  • Restless leg 
  • Oozing foul-smelling liquid discharge from the sore.

If the ulcer is treated early, it will improve without any further complications.  

Causes of venous leg ulcers

Venous leg ulcers can be caused due to many reasons. 

Some of the main reasons are-

  • The increased pressure of blood in the leg veins.
  • Diabetes
  • Infections
  • Minor or major injury 
  • Poor blood circulation

One of the most common causes of the ulcer is the high pressure of the blood in the limbs.

When the leg valves don’t allow the veins to send back the blood towards the heart, the backward flow of blood increases the pressure in the lower limbs or starts to pool blood in the lower leg or ankle. This is how pressure increases in the leg and leads to venous leg ulcers.  

As you may have heard, people with diabetes are less prone to heal wounds. When foot injury doesn’t heal properly due to high blood sugar, it develops into foot ulcers. 

High blood sugar(diabetes) also weakens the walls of the veins and leads to improper blood circulation in the limbs.

Some other cause of venous leg ulcers

  • Hypertension 
  • Heart disease
  • Smoking infections
  • High cholesterol
  • Kidney disease

Is venous leg ulcer hereditary?

It’s a misconception that leg ulcer is hereditary. It is not a hereditary disease. The reasons that may enhance the risk of developing venous leg ulcers that can be genetic. 

The reasons are-

  • Poor valves
  • The tendency of developing a blood clot
  • Twisted or abnormal veins
  • Arteries in the lower limbs

A venous ulcer looks like

A venous ulcer looks like a bumpy large open, and the deep moist wound may be covered in a yellowish or greyish layer. Often, the foul-smelling liquid discharge comes out of the ulcers.  

Venous leg ulcers give some signs before appearing. These signs are-

  • Leg swelling
  • Painful to sit or stand for long periods
  • Patches on the skin
  • Brown spots
  • May the skin of the leg look red or blue
  • Skin becomes itchy and scaly
  • Tingling in leg
  • Heaviness in leg

Who is at risk?

Venous leg ulcers are common in both men and women. It is more common in older people.

Risk factors for venous leg ulcers

  • Varicose veins
  • Older age
  • Family history of venous insufficiency or blood clots (DVT). 
  • Obesity
  • Diabetes 
  • Surgery 
  • Trauma
  • Any leg fracture
  • Minor or major injures 
  • Pregnancy 
  • Sitting or standing for an extended period
  • Osteoarthritis.

Treatment for venous leg ulcer

Venous leg ulcers can be cured with treatment. There are numerous treatment options available to treat venous leg ulcers. 

Treatment options depend on the chronicity and severity of the leg ulcer.  

Here are the treatment options:

  • Compression therapy
  • Cleaning and dressing the ulcers
  • Steroid cream for irritation and itching
  • Sclerotherapy
  • Surgery (In severe cases)
  • Aspirin therapy
  • Pentoxifylline
  • Leg elevation
  • Compression therapy

In this therapy, compression bandages or stockings are used to treat venous leg ulcers. They are specially designed to put pressure and squeeze the leg.

Compression bandage puts constant pressure on the legs externally, that pressure enhances the blood flow to some extent and encourages the blood flow back towards the heart.

  • Cleaning and dressing the ulcers

It is essential to clean any wound properly so that the wound won’t progress further. Similarly, the first step is to clean and remove the dead tissues over the ulcer and then apply proper clean and dry dressing on the ulcer.  Cleaning and dressing provide the best condition to heal the ulcer. 

The dressing should be changed once or twice a week.

  • Steroid cream

A study has shown that the use of topical corticosteroid or steroid cream on the wound improves the wound and starts healing. It reduces pain, irritation, and itching around the lesions. 

Steroids are used widely to treat chronic wounds. 

  • Sclerotherapy

Sclerotherapy is a minimally invasive treatment that is the most widely used procedure to treat leg ulcers. It offers impressive results and rapidly heals ulcers.  

  • Surgery

Surgeons recommend surgery for venous leg ulcers only when the painful sores are deep and don’t respond to other therapies or the ulcer developed into severe conditions. 

Debridement surgery

In this surgery, the surgeon removes the infected tissue or dead tissue to enhance healing. 

There are six methods to operate debridement. These are-

  1. Surgical debridement
  2. Sharp debridement
  3. Mechanical debridement
  4. Enzymatic debridement
  5. Autolytic debridement 
  6. Biosurgical debridement.
  • Aspirin therapy

Researchers say that aspirin therapy improves healing. 300mg aspirin suppresses inflammation and promotes ulcer healing. 

  • Pentoxifylline

Pentoxifylline is a drug that enhances blood flow and maintains proper blood circulation. It is suggested that 400mg tablets taken three times a day increase the chances of healing.

  • Leg elevation

Leg elevation encourages the blood flow. It also enhances the activation of white blood cells and reduces edema. Leg elevation helps a lot to maintain the blood circulation in the limbs. 

Most of the leg ulcers cured within 3-4 months of treatment, but it may also take a longer period according to the severity and chronicity of the ulcers. 

Preventions to avoid venous leg ulcers?

Venous leg ulcers can be prevented by changing the lifestyle and following the precautions.

  • Control high blood pressure and diabetes
  • Exercise regularly
  • Keeps leg elevated
  • Avoid sitting and standing for too long (If you can’t avoid it, then frequently lift your leg when possible)
  • Maintain weight
  • Avoid smoking and alcohol consumption
  • Be careful don’t hurt your leg
  • Wear compression bandages or stockings
  • Daily walk for at least 20-40 minutes

If any of the signs, as mentioned above, notice in your leg, then it is best to consult a vascular surgeon as quickly as possible before the ulcers develop into serious issues. 

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