Leg ulcers are common approximately 2%of adults will have a leg ulcer at some stagetheir lives. Literally thousands of peopledevelop a leg ulcer each yearthe 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 breakthe epithelium ofa body surface or lining. Many of us will be familiar with a mouth ulcer. This is abreakthe 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 problemsthe arteries thatcarry blood into the leg. About 95% of venous leg ulcers can be correctly identified bytheir appearance, by checking for pulsesthe 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 onlythe superficial veins,the veins under the skin, orthe 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 eradied.
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 mediion 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