Complications of venous leg ulcers

What is a Leg Ulcer?

It occurs on a patient’s leg, in the area under the knee or on the foot. It is a patch of injured skin, and it needs more than six weeks to substantially improve. Among the signs of the ailment we have soreness, itch and swollen areas of the leg.

What Types of Leg Ulcers are there?

Most frequently patients suffer from venous leg ulceration, which is responsible for 80-85% of instances of the disease. This condition is usually a result of high blood pressure which lasts for a prolonged period of time, injuring the veins permanently.

There are other types of ulcers, such as arterial (occurs when there is insufficient or bad circulation in the arteries) or diabetic (occurs in patients suffering from diabetes with high blood sugar).

What can Increase the Risk of Leg Ulcer?

There are two factors of risk that most commonly induce leg ulceration in patients: firstly, various degrees of immobility, and secondly being overweight.

What is the Prognosis?

Smaller scale ulcers are a condition that can be cured fairly easily. If a suitable therapy is applied, 70% of such instances of ulcer can be completely gotten rid of after 12 weeks of treatment. On the other hand, bigger ulcerations are more or less harder to dispose of. The typical treatment procedure includes washing and disinfecting the sore area of the skin and applying compression gauze or bandage in order to ensure the blood pressure in the leg is more controlled.

Be Aware of the Underlying Cause

The most immediate symptoms of leg ulcers, such as swelling or damaged skin, can be more or less easily taken care of. Once you get rid of the aforementioned symptoms, make sure to properly address the underlying cause behind the condition. If you fail to do this, the ulceration may reappear and you are back to where you started from.

The Most Common Complications of Leg Ulcer

There are several complications that can stem from the leg ulcer. One of them is immobility, and this is a tough one since it tends to drag you into the ‘vicious circle’ of immobility. For example, you have been more or less immobile and then developed an ulcer. However, now the ulcer can prevent you from being active, and being bedridden only aggravates your circulation. In turn, your ulcer gets worse and you can walk less and less.

Also, ulcerations tend to be closely linked to infections of the ulcerous skin. The symptoms include swollen and red skin and intense aches in the affected area. Also, you may be febrile and experience a general feeling of ill-being.

Patients with leg ulceration often have long-lasting and recurrent wounds. The treatment exists mainly of wound care and compression therapy. International literature shows several indications of problems in relation to leg ulceration, but no studies were performed to give a comprehensive overview of all problems identified and care received related to these problems.

The study had a descriptive, cross-sectional design. A sample of 141 patients was taken from the population of outpatient clinics of seven hospitals in the Netherlands. Data were collected through patient interviews, questionnaires and wound observations. Medical information was provided by the dermatologist or derived from the patients' medical file.
The study identified a number of serious problems. The main problems were pain (85%), outdoor mobility (47%) and problems in finding appropriate footwear (60%).
Statistical analysis showed no differences between patients with ulcers based on venous etiology and ulcers based on mixed etiology. Fifty to seventy percent of the patients did not receive any care in relation to these problems.
Only a rather small proportion of the patients, however, regarded the help as insufficient.

✓ Fact confirmed: Ulcer-related problems and health care needs in patients with venous leg ulceration: a descriptive, cross-sectional study Maud M. Heinen, Anke Persoon, Peter van de Kerkhof, Marisol Otero, Theo van Achterberg; 2007 Nov.