Do you have wounds on your legs that won't heal? Let's learn everything about Leg Ulcers!

When we get a small wound on our leg, we all think that it will heal in a few days. But sometimes, these wounds can take weeks, even months, to heal, leaving you in trouble. That's how we're going to talk about the annoying wounds that form on our legs, which take a long time to heal. In medical terms, these are called `(Leg Ulcers)`.

What are these non-healing leg ulcers?

Simply put, a leg ulcer is a wound that has not healed for more than two weeks despite treatment . These ulcers are usually found in the area between your ankle and knee.

These wounds often ooze fluid (possibly pus) . If not treated properly, these wounds can get bigger. For example, if you have a leg wound and it doesn't heal after three months of treatment, we consider it a chronic condition .

According to statistics from some developed countries of the world, about 1% of adults suffer from this condition. This problem is especially common among people over the age of 65. About 4% of them may have non-healing wounds on their legs. So this is not something to be taken lightly.

Why do leg ulcers occur?

There can be many reasons why leg ulcers develop. Let's look at the main ones.

1. Vein problems (Chronic Venous Insufficiency)

This is the main reason why leg ulcers occur. The veins in our legs have small valves inside them. These are like doors. Their job is to keep blood from flowing upward, toward the heart, and back down. But when these valves don't work properly, blood can back up and pool in the lower legs .

Think of it like a broken valve in a water pipe, causing water to pool in one place. When blood pools like this, the pressure inside the veins in the legs increases. Then, the very fine blood vessels in the skin can burst. This causes inflammation, itching, dryness of the skin, and eventually the skin cracks and ulcers form.

2. Diabetes (Diabetes Mellitus)

You know that diabetes (`(Diabetes Mellitus)`) is a disease that can cause many complications. Because the blood sugar level of a person with diabetes is constantly high, fat deposits build up inside the blood vessels, clogging them up . Just like rust builds up inside an old water pipe.

When the veins become blocked like this, the amount of blood flowing to the legs decreases. Therefore, the nerves can be damaged . We call this `(Diabetic Neuropathy)`. When the nerves are weakened like this, you may not feel even a small wound or cut in your leg. Sometimes, even a small cut that gets stuck in your shoe may not be noticed until it becomes a big wound. Also, wounds heal very slowly due to diabetes .

3. Peripheral Artery Disease (PAD)

In this condition, something similar to diabetes happens. Fat deposits (atherosclerosis) form inside the arteries that carry blood to our body's limbs, gradually clogging those arteries. To be precise, the main arteries that carry blood to our legs become blocked .

What happens then? The legs don't get enough blood. So they don't get enough oxygen and nutrients. When this happens, even a small wound takes a long time to heal. People with diabetes are also more likely to develop this condition (PAD) .

4. High Blood Pressure / Hypertension

High blood pressure (hypertension) is also a silent enemy. If it is not well controlled, it can cause a very painful ulcer (Martorell ulcer) on the lower leg, especially in the ankle. High blood pressure causes the tiny blood vessels (capillaries) in the skin to become blocked, cutting off blood supply to the skin. The skin cells then die and appear as an ulcer.

Who is at higher risk of developing leg injuries?

Some people are more likely to develop these leg injuries than others. Let's see who they are:

• For women: Women are about twice as likely to develop this condition as men.
• Excess body weight: This risk can be increased due to obesity or weight gain during pregnancy.
• Family history: If someone in your family has vein problems (e.g., varicose veins), you may also develop this condition.
• Other medical conditions: People with diseases such as diabetes, high blood pressure, and rheumatoid arthritis.
• Surgery: For those who have had hip replacement surgery or knee replacement surgery.
• Injuries and accidents: Serious injuries such as broken bones.
• Lack of physical activity: For those who stay in one place for too long, don't walk, and have conditions like paralysis.
• Smoking: Smoking can damage blood vessels and impair blood flow.
• Other vein problems: For those with conditions such as varicose veins, vasculitis, and venous thromboembolism.

What are the symptoms of a leg ulcer?

When you have a leg wound, how do you recognize it? Here are some of the main symptoms:

• Non-healing wound: This is the main symptom. If the wound does not heal after two weeks of treatment, it may be a `(Leg Ulcer)`.
• Appearance of the wound: The wound may be red, purple, brown, or yellow . Sometimes, several of these colors may appear mixed together. The wound may also ooze fluid or something like pus .
• Skin changes:
• The skin around the wound may become dry, scaly, and itchy .
• Things like hard lumps on the skin may appear, or the skin may become tight.
• The skin color may change and appear red, blue, or purple, like a bruise .
• Pain: You may experience leg pain, especially after standing for a long time .
• Swelling: Swelling (edema) may be seen in the lower legs.

How to recognize leg ulcers?

If you have these symptoms, you should definitely see a doctor. Usually, a vascular specialist will examine these wounds. He or she will carefully examine your skin and the wound.

In addition, you can also do tests like these:

• Ankle-brachial index test: This uses ultrasound technology to measure blood pressure and blood flow in the legs.
• Biopsy: A sample of skin cells and fluid from the wound are taken and examined under a microscope to check for infections or other skin diseases.

How to treat leg wounds?

Leg ulcers can be a bit difficult to heal. Sometimes , even with treatment, the ulcers can last for months or even years . But don't worry, they can be cured if treated properly.

Treatment options depend on factors such as the type of injury and its cause. The doctor's main goals are to:

1. Healing the wound.

2. Reducing swelling.

3. Preventing the wound from recurring while it heals.

Here are some of the main treatment methods:

• Compression therapy: To help improve blood circulation in the legs, special types of stockings (compression stockings) or bandages are used. These apply pressure to the leg, helping to push the blood up.
• Leg elevation: Keeping your legs elevated above your heart for at least an hour a day, for at least six days, helps blood flow back to the heart.
• Wound care: This is very important.
• Having a doctor remove the dead skin from a wound (`(debridement)`).
• Using topical antiseptics to prevent infection.
• Change the bandage on the wound regularly.
• Medicines:
• If there is an infection in the wound, antibiotics may be given.
• Medications (vasodilators) that help widen blood vessels and improve blood flow may also be given.
• Hyperbaric oxygen therapy: This is a special treatment method. You sit in a high-pressure chamber and breathe pure oxygen. This increases the amount of oxygen in your blood, which speeds up wound healing.
• Treatment for veins: If you have problems like varicose veins, you can undergo treatments like sclerotherapy (injecting medication into the veins) or endovascular ablation (heating the veins from the inside and sealing them off).
• Surgery: Sometimes surgery may be needed to remove, repair, replace, or bypass a damaged artery.
• Skin grafts: If the wound is larger than 4 inches, or if other treatments do not heal, skin from another part of the body can be taken and grafted over the wound.

How to prevent leg ulcers?

Even if a leg wound heals, it is very likely to recur . Therefore, it is very important to take care of these things:

• When you are sitting or sleeping, make a habit of keeping your legs higher than your heart . You can place something like a small pillow under your legs.
• Maintain a healthy weight . Get plenty of physical activity . Walking a little every day is also good.
• If you have conditions that affect blood circulation, such as diabetes, high blood pressure, high cholesterol, or Raynaud's syndrome, control them well . Follow your doctor's instructions carefully.
• If you are a smoker, definitely stop . You can also seek help from a doctor for this.
• To prevent skin from drying out, use gentle cleansers . Apply a moisturizing lotion after bathing.
• Wear compression stockings or bandages for at least an hour a day. This will improve blood flow to your legs. Ask your doctor to choose the one that is right for you.

What are the possible complications of leg ulcers?

If non-healing wounds persist, they can cause further problems.

• Bone infection (Osteomyelitis): The wound can go deep and cause an infection in the bones. If this becomes severe, it may even lead to amputation.
• Cellulitis: A serious bacterial infection of the skin and tissues beneath the skin. The area around the wound may become red, swollen, and warm.
• Sepsis: If the infection reaches the bloodstream, it can be life-threatening.
• Skin cancers: A type of skin cancer (squamous cell carcinoma) can sometimes develop from long-standing, non-healing wounds.

What is the outlook for someone with a leg injury?

Leg injuries can sometimes lead to disability . These injuries can make it difficult to walk, work, and live a normal life. They can require frequent visits to doctors, wound clinics, and even hospitalization.

When should I see a doctor?

If you have a non-healing wound on your leg and are also experiencing any of these symptoms, see a doctor immediately :

• Fever or feeling cold.
• If there is severe pain associated with the injury that prevents you from sleeping or performing daily activities .
• Signs that the wound is infected: redness around the wound, warmth, swelling, and a foul-smelling discharge from the wound.

What should I ask my doctor?

When you go to see the doctor, it's a good idea to ask these questions:

• "Doctor, why did I get this wound on my leg?"
• "What is the best treatment I can have?"
• "What changes can I make to heal this wound and prevent it from happening again?"
• "What are the specific signs I should be concerned about for complications?"

Leg ulcers are painful, uncomfortable, and take a long time to heal. Therefore, specialized wound care is needed to prevent infection and help the wound heal.

Finally, things to remember (Take-Home Message)

So, as we've discussed, a non-healing leg ulcer (`(Leg Ulcer)`) is not something that can be easily treated. But, don't panic. If you have this problem, the first thing you need to do is see a qualified doctor, find out the exact cause, and start proper treatment.

Following your doctor's instructions carefully, taking proper care of your wound, quitting smoking if you smoke, controlling your weight, and managing any underlying conditions like diabetes can go a long way in helping you manage this condition. Remember, these wounds can recur even after they heal, so it's important to continue to follow your doctor's instructions. Wishing you a speedy recovery!

` Leg ulcers, diabetes, high blood pressure, vein problems, wound healing, skin diseases