When Wounds Don’t Heal: Defining Leg Ulcers and Possible Remedies

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Many ailments go hand in hand with aging, even for the healthiest of people, but there are some conditions that are more concerning than others. Leg ulcers are a common occurrence among older adults that can be both painful and difficult to treat, especially when the underlying medical problem causing the ulcer is unknown or misdiagnosed. Open sores on the leg are experienced by one in 500 adults up to age 80, and one in 50 for those older than 80, making it necessary to understand how leg ulcers develop, how to prevent them, and treatment options.

Defining Leg Ulcers

The simple definition of a leg ulcer is an open wound that takes more time than usual to heal. On average, leg ulcers remain open and exposed to the elements for several weeks up to several months, causing pain and discomfort in the form of itching, swelling, and a pungent odor. For some individuals, leg ulcers leak fluid while they remain open, and this can lead to bacterial infections that are a challenge to correct without medical intervention. Most leg ulcers appear just above the ankle after an injury, like bumping into an object or cutting the skin.

While leg ulcers may seem like the body’s response to a slight injury, there is often an underlying issue that causes leg ulcers to form. An estimated 85% of leg ulcers develop because of a breakdown of the veins within the legs, known as venous reflux. Through this process, the veins are unable to move blood back to the heart properly which results in pooling around the affected vein. Varicose veins develop, and an injury to the leg or ankle then leads to a painful leg ulcer. Many older adults develop vein issues as a natural part of aging, but those who have a family history of varicose veins are at higher risk of experiencing a symptom like a leg ulcer.

In addition to genetic predisposition, individuals who carry excess weight have a higher propensity of developing venous reflux over time. Similarly, vein issues may be the result of other health conditions, such as experiencing deep vein thrombosis, undergoing a knee or hip replacement surgery, or having osteoarthritis. Because blood circulation is poor in individuals with these conditions, leg ulcers are far more likely to develop even when the slightest of injuries take place.

Treatment and Prevention

Although leg ulcers as a result of venous reflux and varicose veins are uncomfortable to experience, there are several ways individuals can correct the issue and work toward prevention of additional symptoms in the future. Eddie Chaloner, vein specialist with Radiance Vein Clinic, explains that advances in technology have made the correction of varicose veins far more accessible to individuals experiencing painful and disruptive symptoms. He shares that the addition of minimally-invasive techniques can help solve the underlying issues that lead to leg ulcers, but only when those issues are diagnosed early.

One of the most notable advances in treating the leading culprit of leg ulcers is endovenous vein treatment or ELVT. As a minimally-invasive procedure conducted under local anesthesia, individuals with broken down veins have a small IV injected into the affected area, and a laser is then used to seal the vein off completely. Over time, the body works to absorb the treated vein which results in less noticeable bulging and twisting beneath the skin. The healthy veins around the treatment area are then able to move the blood back to the heart in the correct direction, without causing venous reflux and pooling. When varicose veins are treated in this manner, leg ulcers are less likely to return as a result of unhealthy veins.

There are also conservative measures that can be taken to help treat the underlying cause of leg ulcers, including compression bandaging or stockings, elevation, and a change in lifestyle. Compression treatments use pressure on the legs to ease the flow of blood back to the heart, taking some of the strain off varicose veins. While helping to alleviate the discomfort and pain of unhealthy veins, compression treatments do not always offer a complete solution to the problem. Similarly, elevation of the legs above the heart can be beneficial in reducing the swelling and heaviness of legs with varicose veins or venous reflux; however, this is a temporary fix. Individuals may also be encouraged to lose weight through a change in diet or participating in more physical activity to help reduce the pressure put on the legs over time. Leg ulcers as a result of venous reflux and varicose veins are not a permanent problem for individuals who experience them, but it is necessary to treat the underlying cause effectively should ulcers appear.

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