Published Nov 2024

What are Leg Ulcers?


Leg ulcers are open sores, usually on the lower legs, that fail to heal properly. They’re pretty common in the UK, especially among older adults. In fact, around 1% of UK adults have an active leg ulcer at any time, and about 1 in 50 people over 80 are affected. They can be painful, itchy, or tender, and often become chronic, sometimes recurring over time. Common causes include poor circulation, lifestyle factors (like smoking or obesity), and health conditions such as diabetes and hypertension.

There are many different types of leg ulcers

Venous Ulcers: These make up 70-80% of all leg ulcers and are usually found on the inner leg above the ankle. They’re caused by poor blood flow due to venous insufficiency, where blood pools and builds up pressure in the veins. Risk factors include varicose veins, past deep vein thrombosis (DVT), and obesity.

Arterial Ulcers: Caused by poor blood flow through the arteries (often due to peripheral artery disease), these ulcers are more common on toes, feet, and lower legs. They’re more prevalent in women, especially after age 65, and risks increase with smoking, diabetes, and high cholesterol.

Diabetic (Neuropathic) Ulcers: Common in people with nerve damage from diabetes, these ulcers typically appear on the feet, especially under pressure points. They’re often painless but need close monitoring due to the risk of infection.

Pressure Ulcers: These result from prolonged pressure on the skin and are common in people with limited mobility. They can appear anywhere on the body, including the legs, especially over bony areas.

Treating Leg Ulcers

Treatment depends on the ulcer type and severity, but the basics are cleaning the wound, removing any dead tissue, and using proper dressings. Infection control, pain management, and ongoing monitoring are essential. Each type of ulcer requires slightly different treatment:

Venous Ulcers: Treated with compression therapy to improve circulation and reduce swelling, along with lifestyle changes, like weight management and avoiding prolonged sitting or standing.

Arterial Ulcers: Compression isn’t used. Instead, treatment focuses on improving blood flow, possibly through medications, and managing blood pressure and cholesterol.

Diabetic Ulcers: Proper blood sugar management, regular cleaning, and dressings are vital. Specialised footwear can reduce pressure, and in some cases, surgery to improve blood flow may be necessary.

Pressure Ulcers: Frequent repositioning and special cushions or mattresses help prevent pressure build-up on the skin. Good skin care, proper nutrition, and hydration also support healing.

For ulcers that don’t heal, advanced treatments like biological dressings, skin grafts, and hyperbaric oxygen therapy can help. These treatments aim to increase oxygen to the tissues, promote healing, and reduce recurrence.

Without the right treatment leg ulcers can becoming very difficult to manage. Our experience tells us that identifying the type and cause, followed by regular wound follow-ups, lifestyle changes, and a commitment to the treatment plan will make a big difference in successful management and healing.

If you do have concerns about leg ulcers take prompt action and contact your Concierge Medical doctor now. At Concierge Medical we have significant in house wound management expertise with our resident Queens Nurse, Sam Day and Senior Practice Nurse Rhona Peach.

Concierge Medical aims to provide our members with the best private medical care available in the UK. We believe our home visiting practice has many benefits, one of which is being able to detect, diagnose and treat before health concerns become a health crisis.

For more information about Concierge Medical Practise membership contact 01451 600900 or practice@conciergemedical.co.uk

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