An Explanation of Chronic Leg Ulcers

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Leg ulcers are loosely divided into two categories. Those that are caused by some type of trauma to the leg and will heal up like a normal wound are called “acute ulcers.” Ulcers that remain open or continually appear over and over are called “chronic leg ulcers.” Chronic leg ulcers are usually associated with some type of disease process and often are related to circulatory and nerve disorders in the lower extremities.

Chronic leg ulcers are found mostly below the knee.

Because of impeded arterial or venous blood flow, tissue damage occurs. This damage results in the skin eroding and an ulcer developing in the area. Because of gravity, the lower leg and foot are particularly vulnerable to poor circulation. This creates problems for the skin and muscle that can bring about ulcers.

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Nerve damage can make chronic leg ulcers more likely.

Any disease process that brings about nerve damage is going to be a cause for ulcers forming on the legs. Diabetics are particularly susceptible to this type of damage and chronic leg and foot ulcers. When you cannot feel damage to the skin or tissue when it happens, scapes, puncture wounds, cuts, and even blisters can deteriorate into ulcers that will not heal.

Diabetes and other diseases not only affect the nerves but slow the healing process.

Because of other effects of the disease process, diabetics find that any wound does not heal rapidly. Without extreme care being given to damaged toes, cuts, and other open areas below the knee, ulcers not only occur but grow worse. Gangrene can set in as the tissue dies in the area. Toes, feet, and legs have be amputated to stop the spread of poisons generated by chronic ulcers that developed severe infections and necrotic tissue.

Chronic leg ulcers do not produce pain unless infection occurs.

Because of the nerve and tissue damage, pain is not a feature of chronic ulcers of the leg and foot. However, when the tissue become swollen and inflamed from infection, the pain can be slight or quite intense. This is why those who suffer from diabetes are encouraged to do daily inspections of their feet and legs. By the time the pain is felt, it can be too late to save a body part from amputation.

In order to treat chronic leg ulcers, good blood flow must be returned to the area.

Returning a good flow of blood both to and from the affected area is critical to the healing process. Exercise and elevation are the two methods most often used. In extreme cases, surgery to bring a better blood supply to the area may be required. In the worst cases, chronic leg ulcers may need to have skin graft performed to close the wound.

Reference:

http://dermnetnz.org/site-age-specific/leg-ulcers.html