A leg ulcer (ulcus cruris) is a chronic, poorly healing wound on the lower leg. It usually occurs due to circulatory problems, which prevent the skin and underlying tissue from receiving enough oxygen and nutrients. As a result, a small wound can develop into a large, open sore that is difficult to heal.
There are two types:
- Venous leg ulcer (80-90% of cases): Caused by poor drainage of blood in the veins.
- Arterial leg ulcer: Caused by inadequate supply of oxygen-rich blood to the leg.
Symptoms and Progression
- An open wound on the lower leg, often around the ankle.
- Slow healing, sometimes taking months or even years.
- Pain, especially when standing or walking.
- Redness and swelling around the wound.
- Skin discoloration (brownish or bluish tones due to blood accumulation).
- Possible odor or wound fluid if an infection occurs.
An untreated leg ulcer can continue to enlarge and may lead to serious infections.
Causes of Leg Ulcer (Ulcus Cruris)
Leg ulcers develop due to circulation problems in the legs.
Causes of Venous Leg Ulcer (Poor Blood Drainage):
- Varicose veins or chronic venous insufficiency.
- Prolonged standing or sitting without movement.
- Previous thrombosis (blood clot in the vein).
- Aging (reduced elasticity of veins).
Causes of Arterial Leg Ulcer (Poor Blood Supply):
- Smoking (damage to blood vessels).
- Diabetes (poor wound healing).
- High blood pressure or high cholesterol (narrowing of blood vessels).
- Peripheral arterial disease (PAD) (poor blood supply due to blocked arteries).
Other Risk Factors:
- Overweight (extra pressure on the legs).
- Genetic predisposition (family history of vascular diseases).
- Lack of physical activity (poor circulation in the legs).
Diagnosis of Leg Ulcer
A doctor diagnoses a leg ulcer based on:
- Physical examination: Inspection of the wound and checking for swelling and discoloration.
- Doppler ultrasound: To assess blood circulation problems.
- Blood tests: To check for underlying causes such as diabetes or infections.
- Biopsy or wound culture (if uncertain): To rule out infections or other skin diseases.
Treatment of Leg Ulcer
The treatment focuses on improving circulation and promoting wound healing.
Medical Treatments:
- Compression therapy (for venous ulcers): Compression bandages or stockings reduce swelling and improve blood drainage, promoting faster healing and preventing new ulcers.
- Wound care: Regular cleaning and dressing with special wound materials.
- Antibiotics (for infections): Only prescribed when there are signs of a bacterial infection.
- Surgical procedures (for arterial ulcers): Such as a bypass or angioplasty to open blocked arteries.
- Skin grafting (for very large or persistent wounds).
It is important to consult a specialized wound nurse or dermatologist for the proper treatment.
Self-Care and Prevention
- Wear compression stockings if you have poor circulation.
- Elevate your legs while resting to promote blood flow.
- Avoid prolonged standing or sitting without movement.
- Walk and exercise regularly to improve circulation.
- Quit smoking to maintain healthy blood vessels.
- Keep your skin moisturized and regularly check for wounds.
- Wear comfortable shoes to prevent pressure sores and new wounds
