Venous and Arterial Ulcers Explained
It’s estimated that 1 in every 100 Australians will develop a leg ulcer at some point in their lives, making it a very common skin complaint. Leg ulcers can be painful, embarrassing, and a sign of more significant health problems. They should be examined and attended to as soon as possible by a general practitioner or ideally, an experienced vascular surgeon.
What are leg ulcers?
Broadly speaking, an ulcer is defined as a sore that is slow to heal or keeps returning. You can develop ulcers anywhere throughout your body. They often occur inside the mouth or on the lining of the stomach.
An ulcer on the outer surface of your skin is different from a regular cut or scrape. Whilst the latter may only affect the first few layers of the skin, an ulcer is sunken and clearly defined. The other defining factor of ulcers is how long they take to heal. It can take months for this type of laceration to disappear, only to return a short while later.
Identifying an ulcer
It’s unlikely that you will mistake an ulcer for a normal scrape; the symptoms are quite notable and persistent. They might include:
● Location: usually on the lower leg or ankle
● Foul-smelling fluid seeping from the wound
● Dry skin surrounding the wound
● Extreme itching
● Painful swelling
● Pigmented, hardened, or calloused skin
If an ulcer is left unattended, an infection can strike, causing fever and additional pain and swelling. At the first sign of an ulcer — particularly if you’ve never experienced this condition before — speak to a doctor immediately.
What causes leg ulcers?
The most common type of leg ulcer is a venous ulcer.
Arteries and veins are two types of channels that make up the vascular system, alongside capillaries. While arteries carry oxygenated blood away from the heart and to our muscles, tissues, and organs, veins carry deoxygenated blood and associated waste back to the heart, which then pumps it into the lungs and kidneys to be re-oxygenated and filtered clean.
Often, veins are fighting against gravity to deliver blood upwards through the legs. Several mechanisms help achieve this, including valves and contracting muscles. Over time, a number of different conditions can interfere with the ability of veins to pump blood in the required direction. Persistently high pressure, blood clots, and varicose veins can all cause degradation of vein walls, manifesting in visible ulcers.
Arterial ulcers have a similar appearance and are generally caused by poor blood circulation. Lack of blood supply and oxygen to pre-existing cuts can cause what starts as a minor scrape to turn into an ulcer. Diabetics are more prone to ulceration because of a combination of poor circulation, impaired immunity, decreased sensation and structural changes in the shape of their feet.
Treating leg ulcers
If you have noticed a cut on your leg that is refusing to heal, your first call should be to your doctor. They will be able to take a closer look and determine whether you have developed a leg ulcer. From here, they may recommend you contact a vascular surgeon.
Seeing a vascular specialist is very important, particularly if the underlying cause of your ulcer is some sort of vascular disease. Poor circulation and weakened vein walls can point to other, more significant health problems. Identifying this as soon as possible will enable the surgeon to recommend an appropriate course of treatment that fixes the root issue, not just the superficial wound.
Treating a leg ulcer itself may involve applying a dressing, wearing a compression bandage, elevating your affected leg, and taking antibiotics if the wound has become infected. However, prior to doing this it is important that it is assessed by a doctor such as a vascular surgeon, to diagnose the type of ulcer and treat the blood vessels as required.
Preventing leg ulcers
Understanding the risk factors associated with leg ulcers can help you make positive decisions about your health to mitigate the likelihood that you will develop this condition.
Leg ulcers typically affect:
● The elderly — as we age, our circulatory system becomes less efficient and cholesterol plaque build up over the decades.
● Smokers — cigarettes are a key risk factor that results in blocked arteries and reduced blood flow.
● Those with pre-existing health conditions — diabetes is a strong risk factor for developing a diabetic foot ulcer and this can lead to amputation.
● Patients on medication — certain medications can cause swelling in the legs.
● Overweight individuals — extra weight puts added pressure on veins, causing them to stretch and dysfunction.
Dr Adrian Ling has been providing high-quality vascular care to patients across Melbourne for many years. He regularly treats patients diagnosed with venous, arterial and diabetic ulcers, working in consultation with other health professionals to provide comprehensive care that treats the root cause of the issue. If you are concerned about leg ulcers (or any other vascular condition) and have been searching for a “vascular surgeon near me,” contact Dr Ling today.