This condition is most commonly caused by poor circulation; it may be replant to a variety of disease. Leg ulcers are unhealed injury or open wounds on the legs. Peripheral circulation becomes less efficient with old age. Without treatment, these types of ulcers can keep recurring. Symptoms of leg ulcers are, open sores, pain in the affected area, pus in the affected area, expanded wound size, leg swelling etc. The most common underlying problem causing chronic leg ulcers is disease of the veins of the leg. Many people are not getting the rightful advice and treatment they need so make sure you are getting the right treatment and advice. In combined ulcers, reconstructive arterial surgery is necessary, when potentially practicable, in order to obtain ulcer healing and to prevent recurrence.
Chronic venous insufficiency and leg ulcers affect approximately 1-2 people per 1000 of the general population, with approximately 10-20 people per 1000 developing ulcers during their lifetime. Ulcer healing rates can be poor with up to 50% of venous ulcers present and unhealed for 9 months. Ulcer recurrence rates are worrying with up to one third of treated patients on their fourth or more episode. Leg ulcer treatment is costly and affects the quality of life of affected individuals.
Legs that have a poor blood supply will need intervention to restore the blood flow. This is usually done by angioplasty and stenting but occasionally bypass surgery is required. Leg swelling must be controlled and there are a number of options. Compression bandages are usually used initially as they are the most effective means of controlling leg swelling. They cannot be taken off and must be kept dry so that showering is difficult. The bandages have to be applied by trained nurses and they are usually changed twice weekly. They are replaced by compression stockings as soon as possible but many people have trouble getting the stockings on and off. Another option is the intermittent compression pump but this can only be used while sitting or standing and so is only suitable for people that do not do much walking.
Ulcers that are due to skin cancer have to be surgically removed and a skin graft may be required to cover the resulting defect. Unless the underlying conditions that contribute to your leg ulcer are properly identified the correct treatment cannot be instituted. The most important first step is assessment of blood supply and an arterial ultrasound may be required. If there is a need for surgery then this will be arranged.
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