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No one likes leg ulcers

August 2016

Nearly half a million people in the UK suffer from leg ulcers and, as with so many health problems, leg ulcers affect people more as they age.
Leg ulcers may be common, but they are also very painful, very uncomfortable, and can also look horrible.

Professor Mark Whiteley, an internationally respected and renowned expert in this area, has kindly given Laterlife an update on leg ulcers and what can be done.  Interestingly, he says that the common treatment offered for most leg ulcers involves dressings and bandages which only offer a temporary solution rather than target the underlying causes of the ulcers.

What are leg ulcers?

Leg ulcers can come in many forms and affect the lower areas of the leg, commonly from the ankle to the foot. They occur when the skin has broken down to reveal open sores which are unable to naturally heal, and can often become infected if not treated correctly.

Ulcers can be big or small, painful or not painful, smelly or not smelly, wet or dry. There are a great many different appearances of ulcers which can make the condition even more difficult to spot or understand.

What causes the condition to occur?

A leg ulcer is usually caused by an injury that breaks the skin. In most people, an injury will heal up without difficulty, however when there is an underlying problem the skin does not heal properly and the area of breakdown can become an ulcer.

There are two underlying aspects to be aware of…

The most common problem leading to the development of ulcers is when there is a problem with the circulation of blood in your leg veins – often referred to as hidden varicose veins or venous reflux. This increases the pressure inside the veins which gradually damages the tiny blood vessels in your skin, making it fragile and more susceptible to developing a ‘venous leg ulcer.’

A second, and less common, problem is caused by poor circulation of blood in the arteries, which may result in an ‘arterial leg ulcer’. Arterial ulcers are less common than venous ulcers, however they are the most important to diagnose. This is because arterial ulcers are a sign that the leg does not have enough blood supply to keep it alive and, if not restored, can lead to gangrene.

How are leg ulcers treated?

In the vast majority of cases leg ulcers are completely curable with the right treatment. The basic principle of curing a leg ulcer is very simple; find out the underlying cause of the leg ulcer and correct it.

For various reasons many health professionals will not make their patients aware of this, and instead will offer less effective temporary solutions - such as dressings and bandages. Although these temporary solutions can improve the ulcer surface and even temporarily heal the skin, the ulcer will usually break open again as the underlying cause has not been addressed.

For anyone suffering with a ‘venous leg ulcer’, it is important to visit a vascular specialist. Vascular specialists will use a duplex ultrasound scan to identify which veins have lost their valves and are allowing venous reflux to occur, and can close these problematic veins under local anaesthetic using combination of treatments, including;

  • Endovenous laser ablation
  • Radiofrequency ablation
  • Foam sclerotherapy
  • Phlebectomy
  • Perforator vein closure (TRLOP)

Once the underlying problem has been addressed, the ulcer healing usually follows within 3 to 6 months provided the patient is walking well and the ulcer isn't perpetuated by constant dressing.

The cure for an ‘arterial leg ulcer’ is to find where the arteries are blocked and to either open up the blockages using treatments such as balloon angioplasty, arterial stents or bypass grafts. Arterial leg ulcers are well catered for by the National Health Service.

Three years ago Professor Mark Whiteley launched The Leg Ulcer Charity; the first of its kind in the UK. The charity aims to empower those suffering from leg ulcers, giving them the knowledge to understand their condition and to know what to ask for to get a cure if possible – and if not, to find out why not.

Mark has also founded the specialist Whiteley Clinics in London, Guildford, Bristol and Birmingham, with an aim to offer the very best treatments for leg ulcers and other leg problems such as varicose veins, to the UK public.

Their websites are at:

 

 

 

 

More information is also available here.


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