Chronic Leg Ulcers

Vein Procedure

Chronic Ulcers are a common problem seen in people with venous insufficiency, mainly in patients with deep vein reflux. This slow-to-heal sore, which usually affects the lower legs, can be painful, distressing and seriously debilitating if left untreated. Luckily, there are many treatment options for people diagnosed with chronic ulcers on the legs. Dr. Ebanks has years of experience treating patients diagnosed with this condition.

What Are Chronic Ulcers?

Also called venous chronic ulcers, chronic ulcers are shallow wounds that develop in the skin of the lower leg. These wounds are typically seen around the sides of the lower leg, just above the ankle and below the calf. They are slow to heal and may return over and over again; hence the name, chronic ulcer. To be diagnosed with a chronic leg ulcer, the ulcer needs to persist for six weeks.

Chronic ulcers develop when blood flow in the legs is not sufficient to get the blood back up to the heart efficiently — a condition known as venous insufficiency. The blood pools around the tissue in the lower leg and foot, and eventually, a skin ulcer begins to form.

Other symptoms of chronic leg ulcers include:

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Pain, itching and swelling in the leg
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Foul-smelling discharge from the ulcer
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Skin discoloration and hardening
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Inflamed and warm skin

The condition tends to be stubborn and hard to treat; up to half of all of those diagnosed have an unhealed ulcer nine months into treatment. Recurrence is common and treatment can be costly and cause patient distress. In rare cases, the ulcer can become infected and start to become necrotic.

All these things make chronic ulcer a particularly debilitating condition.

Causes of Chronic Ulcer

Over 80 percent of chronic ulcers are due to chronic venous insufficiency, a condition in which faulty veins and vein valves cause blood pooling in the legs. Blood pooling increases leg pressure and leads to fluid buildup, which prevents nutrients and oxygen from reaching tissue. Nutrient- and oxygen-deprived cells start to die and stubborn sores form. These sores are unable to heal at a normal rate due to this lack of normal blood flow. Other underlying factors, such as smoking, old age and a suppressed immune system, can further add to this problem.Chronic venous insufficiency can be a result of aging, deep vein thrombosis, smoking, immobility, family history and many other factors. The condition is more common in people over age 50 and women are usually affected.If you have one of these wounds on your leg, it is important to seek medical assistance as soon as possible. These wounds generally do not heal without medical treatment to get rid of them completely.

Diagnosis and Treatment Options

If you are concerned you may have a chronic ulcer you can visit your general practitioner, or you can contact Dr. Ebanks directly who can assess your condition. Your doctor will perform a physical examination, look at your medical history and refer you to diagnostic testing. Testing can help rule out other conditions and find the underlying cause of your leg ulcer. Commonly performed tests include:

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Ultrasound vascular studies
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X-ray
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CT scan
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MRI scan
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Lab test
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EKG

Once you receive a diagnosis, treating chronic ulcers usually involves two strategies:

Compression therapy

Compression therapy is the most practical, successful and cost-effective way to treat chronic venous insufficiency and leg ulcers. This can involve wearing elastic stockings or bandages during activity and rest. These apply gentle pressure to surface veins in the legs, forcing blood back into the deep veins. Dr. Ebanks can find the right compression strength needed for your particular case. Contraindications for compression therapy include heart failure, uncontrolled high blood pressure, peripheral artery disease (PAD) and diabetes.

Wound Care

Wound care involves cleaning the ulcer, applying dressings and controlling infection. It is important to use substances and materials prescribed to you by your doctor to prevent complications. Your doctor may prescribe topical anesthetics to reduce pain during wound care. The type of dressing used to treat chronic ulcers depends on their severity. Dressings aim to keep the wound moist and disinfected. Others work as skin substitutes and barriers, and some dressings increase collagen production. Dr. Ebanks is experienced in treating chronic ulcers and understands all too well just how stubborn these wounds can be. She understands the origin of the problem — chronic venous insufficiency.

Treating the relevant venous incompetence

To treat chronic ulcers, Dr. Ebanks uses a combination of venous procedures, debridement (removal of dead tissue around the wound), compression stockings and garments ans medication to ensure healing. Dr. Ebanks works with patients for as long as it takes to get rid of chronic ulcers for good. If she sees a case that cannot be effectively treated through her facilities on Grand Cayman, she has a referral network of qualified doctors in the United States to send her patients to. However, many patients have received satisfactory results from the treatments that Dr. Ebanks provides. Dr. Ebanks can also help you address the underlying causes of your leg ulcer, especially in the case of chronic venous insufficiency and other vein diseases.

Make an Appointment

If you have symptoms of a chronic leg ulcer, contact us today to schedule an appointment with Dr. Tanja Ebanks at Cayman Surgery in the Cayman Islands. Dr. Ebanks is a general surgeon who has years of experience treating a wide range of vein conditions and their complications, including chronic venous insufficiency and leg ulcers. She will carefully assess your condition and find the best treatment options for your case. To learn more about your treatment options, call Dr. Ebanks today at +1 345 946 0067 . You can also fill out our online contact form to receive a callback at a more convenient time. You can message Cayman Surgery directly at office@caymansurgery.ky.

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FAQS

Who gets chronic leg ulcers?

Leg ulcers affect one percent of all Americans. Women are more commonly affected, and their prevalence increases with age, with one in 50 people developing it after age 80. People with certain medical conditions and prior deep vein thrombosis and venous insufficiency are more likely to get leg ulcers. Immobility may play an additional role.

How are leg ulcers treated?

Every patient needs an individualized treatment program for chronic ulcers. But most treatments include a combination of compression garments, antibiotics, anti-clotting medication, topical medicine. Usually, you will need the help of an at-home nurse to treat your leg ulcer. Occasionally, patients may treat their ulcers themselves with the help of professional guidance.

How fast can leg ulcers heal?

Venous leg ulcers take an average of six months to heal, according to some studies. With proper treatment, a leg ulcer can heal within three to four months. However, some leg ulcers take longer to heal and others never heal. It is important to address the underlying cause of the ulcer to improve patient outcomes. Patient’s compliance plays an important role.

Why is my leg ulcer not healing?

Some patients with leg ulcers never see their condition improve. The usual cause of non-healing ulcers is deep vein reflux or an untreated underlying condition, such as diabetes mellitus, infection or arterial insufficiency.

What does a leg ulcer look like when it starts?

Before an ulcer appears, you may develop symptoms indicating changes in blood flow in the leg, such as swelling and pain after standing for long periods. Later on, your leg may appear dark and you may develop brown patches of skin. Once the ulcer appears, it tends to be red, moist and bumpy. Later on, it develops a yellow coating.