Leg wounds are a common and difficult problem. Having a chronic leg wound can significantly affect quality of life. Of all leg wounds, 70% are from vein problems.
The vein problems may be from more superficial veins like varicose veins or can occur after a deep vein thrombosis. This is often associated with leg swelling and skin damage. This is known as Post Thrombotic Syndrome.
Some are from other vascular causes such as blocked arteries, with resultant decreased oxygenation of the tissue. In addition, there are other causes of ulceration such as trauma, infection, skin cancers, diabetes and microvascular disease.
Nutrition plays a vital role in wound healing as does normal lymphatic function. Problems with these may delay wound healing.
All leg wounds need to be fully investigated and have a complete vascular assessment.
Treatment depends on the cause.
Superficial Veins – These may require endovenous vein treatments (please do a link)
Deep Veins – these may require vein stenting. (please do a link)
Ulcers caused by veins require compression therapy.
Patients benefit from decongestive therapy to help the lymphatic system.
Nutritional support is essential for optimal wound healing and is advised by wound care nurses, lymphodema therapists and/or a dietician.
An infected wound may require a surgical debridement.
A non-healing wound may require a biopsy to exclude cancer.
A large wound may benefit from a skin graft to accelerate healing
Other causes need treatments on their merits:
Arterial blockage – arterial bypass or stent
Autoimmune / vasculitis – steroids
Associated cellulitis (skin infection) – antibiotics