Lower extremity ulcers are stasis ulcers that occur when blood pools in the veins. Varicose veins can cause venous ulcers. Blockage of circulation in the legs, as in peripheral artery disease, can cause arterial ulcers and nerve damage, known as diabetic neuropathy, from diabetes. Lower extremity ulcers are usually open sores that do not heal.
According to the Wound Health Society, about 15% of older adults in the US suffer from chronic wounds. Venous stasis ulcers, pressure ulcers, and diabetic ulcers account for the majority of these chronic wounds. Researchers have found smoking, obesity, and diabetes to be major risk factors in developing the condition.
The most common cause of lower extremity ulceration is vascular disease. Some diseases associated with this condition are varicose veins, deep vein thrombosis, and trauma. Venous ulcers are the most common, accounting for two-thirds of all types of ulcers. Other causes for ulceration include malignancy (a tumor or cancer), infections, and autoimmune diseases.
Below is a breakdown of the types of ulcers:
● Venous Ulcers result from veins that do not work properly. Elderly people and women are affected most often. Older age, obesity, previous leg injury, deep vein thrombosis, varicose veins, and phlebitis are the primary risk factors.
● Neuropathic Ulcers are caused by uncontrolled blood sugar levels and affect people with diabetes. These ulcers result in a loss of sensation, contributing to further injury and damage.
● Arterial Ulcers are caused by arteries that do not work properly. They often affect people with diabetes who have uncontrolled blood sugar levels. Other causes include diabetes, rheumatoid arthritis, peripheral artery disease, and some rare conditions.
Doctors recommend leg elevation, compression therapy, dressings, medication, and surgery to care for venous ulcers. Leg elevation can reduce edema or swelling in the leg and improve
circulation. For resistant ulcers, surgical procedures such as skin grafts or a vein operation may be necessary.
Venous ulcers take a long time to develop and, in turn, can take along time to heal. The average healing time for a venous ulcer is 3 to 4months, but a small percentage experience longer healing times.
Doctors recommend cleaning, compression therapy, topical medications. Diabetes increases the likelihood of sores and ulcers. People with diabetes are also at a higher risk for atherosclerosis, peripheral vascular disease, and heart disease.
Keeping pressure off your leg with crutches, braces, or other devices can help ulcers heal faster. Patients may also use topical medications like saline, growth factors, and skin substitutes. And, like all people with diabetes, maintaining healthy blood sugar levels will help your ulcers continue to heal properly.
Patients may also find debridement helpful. This process removes dead skin and tissue to help the ulcer heal and prevent infection.
Diabetic ulcers make up more hospitalizations than any other diabetes complications. In the United States, diabetes is the main cause of lower leg amputation. 5% of diabetic patients develop foot ulcers every year, and 1% require amputation.
These ulcers occur as a result of peripheral neuropathy. Treatment for ulcers of this type includes diabetic control, mainly through a change in lifestyle habits such as diet and exercise.
Additionally, you should maintain good hygiene. This will help you avoid infections that can become serious. If the case worsens, amputation maybe required.
To treat this type of ulcer, doctors will try to restore blood circulation to the leg. Additional treatments such as medication and surgery may be required to restore blood flow to tissue and organs.
Angioplasty is recommended for more severe cases. This procedure involves surgically inserting a balloon into the affected artery to improve blood flow. When blood flow is restored,
your symptoms will go away. However, if blood flow can’t be restored, amputation may be recommended.
Lifestyle is a major factor in improving outcomes. Common causes of arterial ulcers include age, diabetes, smoking, high blood pressure, high cholesterol, and kidney failure. Doctors recommend changing bad habits and healthy dieting to improve the condition.
Our board-certified vascular surgeons are trained in the diagnosis and treatment of the diseases of the vascular system. We have served the South Valley for over 10 years and offer patient-centered care and personalized treatments to improve your quality of life. Our three offices are available to serve you in Visalia, Porterville, and Hanford, California. Contact us here for more information. You may also contact us at the numbers listed below:
● Visalia (559)625-4118
● Hanford (559)825-6204
● Porterville (559)788-1022
● Tulare (559)625-4118
● Fresno (559)746-9605