Leg Ulcers 7 Facts About Leg Ulcers You Must Know
Leg ulcers are common approximately 2%of adults will have a leg ulcer at some stage in their lives. Literally thousands of peopledevelop a leg ulcer each year in the United Kingdom and many of those get more leg ulcersas the years go by. Despite the misery they cause, leg ulcers remain a neglected problem.I am going to tell you the 7 essential facts should you know about leg ulcers. Number 1 What is an ulcer? The medical definition of an ulcer is a break in the epithelium ofa body surface or lining. Many of us will be familiar with a mouth ulcer. This is abreak in the cell lining the mouth. It can be caused by an injury such as biting theinside of the mouth by accident. Well if the
skin breaks down anywhere on the body it iscalled an ulcer. If the ulcer is on the leg and has been present for more than 6 weeksit is called a chronic leg ulcer. Number 2 What causes a leg ulcer? Four out of 5 ulcers that's 80% are caused by a problem with the leg vein pump and they are called venousulcers. The leg vein pump is the mechanism by which blood flows out of the leg back tothe heart. So problems with the deep veins such as obstruction from a deep vein thrombosis,superficial vein reflux or perforator vein problems can cause venous leg ulcers. Theleg vein pump depends mainly on good ankle movement, good calf muscles and healthy legveins. A minority of leg ulcers about 15%
are caused by problems in the arteries thatcarry blood into the leg. About 95% of venous leg ulcers can be correctly identified bytheir appearance, by checking for pulses in the feet and by checking sensation. As mostleg ulcers are venous that's what I am going to concentrate on. Number 3 Whereon the leg do you get venous ulcers? Well venous leg ulcers appear on the lower partof the leg usually just about the ankle. Often, there are varicose veins or thread veins aroundthe ulcer and the leg is usually swollen. The skin is often thickened and discolouredby varicose eczema which many actually develop many months or years before the ulcer as awarning sign that the vein circulation is
not normal. Number 4 Who gets a venousulcer? Well these ulcers affect people who have deep vein problems, usually from a pastdeep vein thrombosis (DVT), people who have superficial venous disease or those with anklemobility problems. Leg ulcers are more common as we get older. Number 5 How do you treatvenous ulcers? The aim of treatment is to get the ulcer healed as quickly as possible.This usually means graduated compression either with bandages or compression stockings. Inmost cases, antibiotics, creams and ointments are not necessary. Once the ulcer is healedit is very important to identify any problems with the superficial veins or perforator veinsand that these are treated to reduce the risk
of another ulcer. This means getting a fullassessment with a duplex ultrasound scan. Number 6 Can you cure a leg ulcer? Well thisis controversial. Some would say that if the problem is only in the superficial veins,the veins under the skin, or in the perforator veins that connect these superficial veinsto the deep veins, then the ulcer can be cured. While there is good evidence that such treatmentwill greatly reduce the risks of getting another leg ulcer, if the skin has been very damagedand the ulcer has healed with a lot of scarring, this area of the leg may remain vulnerableand a trivial knock or injury might cause another skin breakdown even though the veinabnormality has been completely eradicated.
Number 7 How can we avoid leg ulcers? Wellthere are 3 things I would suggest. Firstly, if you are unfortunate enough to suffer adeep vein thrombosis (DVT), it should be treated promptly to limit the damage to the deep veins.Unfortunately, damage to the deep veins cannot be reliably reversed by surgery. So, prompttreatment with anticoagulants blood thinning medication reduces the extent of the clotand the damage to the deep veins. Secondly, if you have had a DVT, you should considerwearing good quality medical grade compression socks some studies suggest that doing somay reduce the risk of leg ulcers after a big DVT. Thirdly, if you have superficialvein reflux have it treated early to reduce
CLEAR A Patients Guide to Understanding Offloading Diabetic Foot Ulcers
The purpose of this tutorial is to help you understandthe importance of offloading, the use of special footwear, and helping your foot ulcer healas quickly as possible. Healing quickly can reduce your risk of developing serious complications.Key elements of successful healing are: rest, eat a balanced diet and maintain your bloodsugars in a controlled range, wear the device your tells you to wear at all times,and refraining from smoking. Foot ulcers need rest in order to heal. If you were to breakyour leg, your would tell you not to walk on it. It is the same with your footulcer. We rest ulcers by taking off the load, or offloading the ulcer using special casts,boots, or shoes.
The possible complications from a foot ulcer that fails to heal are: development of an infection,infection spreading to the rest of the body, resulting in ization, amputation atthe foot or leg, or even death. Foot ulcers put you at considerable risk for amputation.Amputation of part of your foot or leg can lead to changes in your ability to do activitiesthat are part of your everyday life. It can lead to a decrease in activity, which canweaken your heart and body, making it difficult to control your diabetes. It can also changethe way you walk or move, potentially causing
damage to your other foot and leg. Most importantly,the challenge of having an amputation can lead to depression and sadness, affectinghow you are able to enjoy your family, friends, and hobbies. Normally, your body's responseto pain is a sharp reflex that allows you to recoil and prevent further injury. Diabetescauses changes to the nerves in your feet, and the ability to feel or sense pain. Itrobs your body of the protective gift of pain, or the ability to protect itself. This conditionis called neuropathy. People with neuropathy can walk with a stone in their shoe and notnotice it. This could cause an ulcer or blister on their foot. A person with neuropathy doesnot know that they have a sore or blister
on their foot because they cannot feel it.By the time you notice the ulcer, it can become very serious. This is why it is importantto check your feet every day for problems. Diabetes can cause the skin on your feet tobecome very dry, creating cracks that later become sores or infections. Ask a torecommend a good moisturizer for your feet and heels. People with diabetes can also havechanges in their leg and foot circulation. This reduces the oxygen, nutrients, and bloodsupply to your leg, increasing your risk of getting an ulcer and slowing your abilityto heal. Your may order a test to examine your circulation. Because of these factors,simple everyday activities such as walking
or standing on your injured foot can be harmfulto your healing ulcers. It could worsen the condition or cause infection. If you smoke,it is important that you talk to your about treatments to stop smoking. Smokingis a large reason why people develop circulation problems in their legs and feet. Continuingsmoking will slow healing to your ulcer and likely make your circulation worse. The bestway to heal your diabetic ulcers is to take off the load by using special casts, boots,or shoes. It is important to wear these all the time, even if you are only taking a fewsteps. The best way to heal a diabetic foot ulcer is to use a special cast called a totalcontact cast. Research shows that more people
treated with total contact casts heal thanwith other treatments. These include bioengineered tissues, such as growth factors or syntheticskin substitutes, and negative pressure wound therapy. They also heal faster than with manyof the newer advanced woundhealing technologies. People treated with total contact casts healin an average of 42 days. gt;gt; DOCTOR: Next I'm going to make this irremovableby adding on a layer of cohesive bandages. s can also adapt your diabetic walking boot so that you cannot take it off. Thishas been shown to be just as effective as a total contact cast. Your may usea combination of wound and offloading treatments