What are ulcers?
Ulcers are wounds or open sores that will not heal or keep returning.
What causes leg ulcers?
Leg ulcers may be caused by medical conditions such as:
- Poor circulation, often caused by arteriosclerosis
- Venous insufficiency (a failure of the valves in the veins of the leg that causes congestion and slowing of blood circulation in the veins)
- Other disorders of clotting and circulation that may or may not be related to atherosclerosis
- Renal (kidney) failure
- Hypertension (treated or untreated)
- Lymphedema (a buildup of fluid that causes swelling in the legs or feet)
- Inflammatory diseases including vasculitis, lupus, scleroderma or other rheumatological conditions
- Other medical conditions such as high cholesterol, heart disease, high blood pressure, sickle cell anemia, bowel disorders
- History of smoking (either current or past)
- Pressure caused by lying in one position for too long
- Genetics (ulcers may be hereditary)
- A malignancy (tumor or cancerous mass)
- Certain medications
Steps to take
- Call to schedule a consultation: During your consultation you will be able to ask questions and have your questions answered by a medical professional. This step will help you make an informed decision for your treatment options. Call 727-475-4039
- Day of consultation: Please arrive 20 minutes before your appointment to fill out necessary paperwork and a health questionnaire. Bring any patient history such as previous ultrasound imaging and notes from your primary care doctor (if you have any). During your consultation you will be evaluated based on symptoms and be able to ask questions plus get knowledgeable information to help you make an informed and educated decision on vascular disease treatment and care.
- Return for Ultrasound: If you have not already had diagnostic image testing done, you will return for an Ultrasound and ABI (Ankle Brachial Index, a test to measure the blood pressure in your legs). This test will provide us with the knowledge on which treatment if any needs to be applied.
- The day of your procedure: Please arrive 20 minutes before your appointment time to fill out additional paperwork and to go over simple instructions for your return home. The minimally invasive treatments offered here at Coastal Vascular Specialists are same day procedures, so you will be returning home that day. Please be sure to have someone with you. This person will be given a prescription for pain management if necessary.
What are the symptoms of ulcers?
Ulcers may or may not be painful. The patient generally has a swollen leg and may feel burning or itching. There may also be a rash, redness, brown discoloration or dry, scaly skin.
How are leg ulcers diagnosed?
First, the patient’s medical history is evaluated. A wound specialist will examine the wound thoroughly and may perform tests such as X-rays, MRIs, CT scans and noninvasive vascular studies to help develop a treatment plan.
How are leg ulcers treated?
At Coastal Vascular Specialists, patients are treated by a team of world-class experts in lower extremity wound care. This Clinic includes doctors, physicians assistants, nurses and other medical specialists.
These experts work together to determine the cause of the ulcer and develop an individualized treatment program.
The goals of treatment are to relieve pain, speed recovery and heal the wound. Each patient’s treatment plan is individualized, based on the patient’s health, medical condition and ability to care for the wound.
Treatment options for all ulcers may include:
- Antibiotics, if an infection is present
- Anti-platelet or anti-clotting medications to prevent a blood clot
- Topical wound care therapies
- Compression garments
- Minimally invasive procedures to improve blood flow
Venous Ulcer Treatment
Venous ulcers are treated with compression of the leg to minimize edema or swelling. Compression treatments include wearing compression stockings, multi-layer compression wraps, or wrapping an ACE bandage or dressing from the toes or foot to the area below the knee. The type of compression treatment prescribed is determined by the physician, based on the characteristics of the ulcer base and amount of drainage from the ulcer.
The type of dressing prescribed for ulcers is determined by the type of ulcer and the appearance at the base of the ulcer. Types of dressings include:
- Moist dressings
- Alginate dressings
- Collagen wound dressings
- Debriding agents
- Antimicrobial dressings
- Composite dressings
- Synthetic skin substitutes
Arterial Ulcer Treatment
Arterial ulcer treatments vary, depending on the severity of the arterial disease. Non-invasive vascular tests provide the physician with the diagnostic tools to assess the potential for wound healing. Depending on the patient’s condition, the physician may recommend invasive testing, endovascular therapy or bypass surgery to restore circulation to the affected leg.
The goals for arterial ulcer treatment include:
- Providing adequate protection of the surface of the skin
- Preventing new ulcers
- Removing contact irritation to the existing ulcer
- Monitoring signs and symptoms of infection that may involve the soft tissues or bone
Treatment for neurotrophic ulcers includes avoiding pressure and weight-bearing on the affected leg. Regular debridement (the removal of infected tissue) is usually necessary before a neurotrophic ulcer can heal. Frequently, special shoes or orthotic devices must be worn.
Wound Care at Home
Patients are given instructions to care for their wounds at home. These instructions include:
- Keeping the wound clean and dry
- Changing the dressing as directed
- Taking prescribed medications as directed
- Drinking plenty of fluid
- Following a healthy diet, as recommended, including plenty of fruits and vegetables
- Exercising regularly, as directed by a physician
- Wearing appropriate shoes
- Wearing compression wraps, if appropriate, as directed
How can ulcers be prevented?
Controlling risk factors can help you prevent ulcers from developing or getting worse. Here are some ways to reduce your risk factors:
- Quit smoking
- Manage your blood pressure
- Control your blood cholesterol and triglyceride levels by making dietary changes and taking medications as prescribed
- Limit your intake of sodium
- Manage your diabetes and other health conditions, if applicable
- Exercise – start a walking program after speaking with your doctor
- Lose weight if you are overweight
- Ask your doctor about aspirin therapy to prevent blood clots