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Learn about Venous Leg Ulcer

What are leg ulcers?

Leg ulcers can be acute or chronic. Acute wounds are defined as those that follow the normal phases of healing. They are expected to show signs of healing in less than 4 weeks, and include wounds due to trauma or operations.

Chronic wounds are those that persist for more than four weeks, and are often due to complex and poorly understood causes.

A venous leg ulcer is a chronic wound that is caused by poor circulation of blood from your legs to your heart, usually due to faulty valves inside the leg veins.

Healthy valves allow blood to flow up the leg toward the heart and prevent backward flow down the leg. Faulty valves do not stop this backward flow, allowing pressure to build up in the leg veins, with blood pooling around the lower part of the leg that can extend up to the knee. This pressure damages tiny blood vessels in the skin, making the skin become thin and inflamed, and causing it to break down easily. The death of tissue cells leads to the ulcer.

Who is at risk?

Chronic leg ulcers affect about 1% of the middle-aged and elderly population. They most commonly occur in patients with chronic venous insufficiency, or poor circulation in the veins.

Certain conditions may contribute to the development of venous leg ulcers:

  • Varicose veins
  • History of leg swelling
  • History of blood clots, such as deep vein thrombosis (DVT)
  • Sitting or standing for long periods
  • High blood pressure
  • Multiple pregnancies
  • Previous surgery
  • Fractures or injuries in patients with chronic venous insufficiency
  • Obesity
  • Increasing age and immobility
What are the signs and symptoms?
  • Located below the knee, most often on the inner part of the ankles
  • Relatively painless unless infected
  • Associated with aching, swollen lower legs that feel more comfortable when elevated
  • Surrounded by mottled brown or black staining and/or dry, itchy and reddened skin

What are the treatments?

Where possible, treatment aims to reverse the factors that caused the ulcer. The standard treatment for a venous leg ulcer is compression therapy, combined with exercise, elevation and rest. Once the wound is cleaned and the dead tissue removed, a compression bandage is tightly wrapped around the wound, from the toes to the area below the knee, to help push blood away from the area back up to the heart. Compression therapy can be effective, though it may take a long time, and sometimes does not work.

If the wound is infected, an antibiotic may be prescribed to treat the tissue infection. Because wound healing requires certain nutrients, such as protein, iron, vitamin C and zinc, supplements may be prescribed if they are lacking in the diet.

Apligraf® , when combined with compression therapy, has been shown to heal more venous leg ulcers. Of course, as with any medical condition, it is better to prevent a venous leg ulcer than to have to treat one. To learn more about prevention, click here.

Click Here for Examples of Venous Leg Ulcers...

To discover more resources for venous leg ulcer, click here.

References:

1. Bryant, Ruth. Acute and Chronic Wounds: Current Management Concepts. 3rd Edition. Mosby, St. Louis, 2007, pp. 277-298.

3. Falanga V, Sabolinski ML. A bilayered living skin construct (Apligraf®) accelerates complete closure of hard-to-heal venous ulcers. Wound Repair Regen. 1999;7:201-207.

4. Veves A, Falanga V, et al. Graftskin, a human skin equivalent, is effective in management of non-infected neuropathic diabetic foot ulcers. Diabetes Care.
2001;24:290-295.

Venous Leg Ulcer Fast Facts

Find a Wound Care Center

A Wound Care Center is a clinic specializing in the treatment of nonhealing wounds. These centers are often the best place to get treated for venous leg ulcers and diabetic foot ulcers.

Find the Wound Care Center with Apligraf experience nearest you: