Time to take a stand against leg ulcers
O MANY people suffer foot and leg ulcers in silence. An ulcer is breakdown of the skin leading to an open sore. Leg ulcers are surprisingly common and affect one to two per cent of the UK population.
A leg ulcer can be debilitating. It needs to be dressed and bandaged often and can become smelly, which can be embarrassing. Those suffering can lose confidence and not want to leave the house. Mobility can be affected. Overall this leads to a negative impact on lifestyle.
There are a few main causes of leg ulcers. By far the most common type is a venous leg ulcer. These are chronic sores that take many months to heal. Generally, they develop slightly above the ankle, on the inside of the leg. This may follow a minor injury to skin that has been chronically damaged by high pressure in the veins of the leg, known as venous hypertension.
Underlying factors of an ulcer such as this might include obesity, immobility, a history of a deep vein thrombosis or, frequently, varicose veins that have not been treated. The root causes may all need addressing for effective healing. In a small numbers of cases, an ulcer recurs or fails to heal at all.
A person is diagnosed with diabetes every couple of minutes — that is around 700 people daily, as incidences of the disease continue to skyrocket. Indeed, the leading charity in the country which deals with the condition, Diabetes UK, has described it as the most rapidly growing health danger of modern times. The number of people with diabetes has doubled over the past 20 years.
A main issue with diabetes, affecting up to one in 10 patients, is a diabetic foot ulcer (DFU). This arises from blood-vessel damage due to high blood sugars and restricted blood supply to the legs and feet.
The reduced blood supply means that the skin of the feet receive fewer cells to fight infections, so wounds take longer to heal, causing a problem such as a DFU, an open wound or a sore which doesn’t heal as quickly as it should.
Essentially, an area of skin breaks down, exposing the underlying tissue. Sometimes minor surgery is needed and, in rare cases, amputation.
For all patients, a leg or foot ulcer can have severe consequences and a negative impact on their lifestyle. Ulcers of this kind can lead to immobility, the need to sleep in a chair rather than a bed, an embarrassing smell, and, worse of all, constant pain.
TREATMENTS
Treatment varies, depending on which disease process has caused the ulcer but the aim is to reduce infection and allow the skin to heal over the open wound.
With venous leg ulcers, the treatment typically involves dressing the wound and keeping it clean, or maybe using compression stockings or bandages. These improve the venous blood flow in the legs.
Antibiotics are also sometimes prescribed when an ulcer becomes infected but will deal only with overlying infections — they cannot help the healing process.
When an ulcer is due to a decreased blood supply, operations to improve the circulation might be necessary. A vascular surgeon typically looks after patients with leg ulcers.
It is always worth having a duplex ultrasound scan of the leg blood vessels to help diagnose or rule out a circulatory cause behind the ulcer. Scans and other investigations to rule out underlying issues might also be warranted.
OTHER TREATMENT INCLUDES: DEBRIDEMENT
This involves taking all unhealthy tissue away from the wound bed, to encourage natural healing.
OFFLOADING
This means pressure reduction, through properly fitted shoes, socks and insoles, crutches or a wheelchair.
Total-contact or removal casts are other options.
A total contact cast is moulded to the contours of the foot and helps to equally distribute the patient’s weight.
A removal cast is similar but is removable for inspection and treatment of the wound.
SURGIHONEY
This is a newly devised, medical honey which has powerful antimicrobial action. It has been found to be very effective in the treating of hard-toheal wounds and preventing the spread of infection.
BRH® THERAPY
This pioneering treatment, developed in Israel, uses therapeutic ultrasound and electro-stimulation to decrease wounds’ size and depth, or to close them altogether. It boosts blood flow so healing becomes much quicker. This is a revolutionary, painless and non-evasive treatment and results on chronic ulcers are very promising.
NEGATIVE PRESSURE
This uses a vacuum dressing to encourage healing of chronic wounds or burns. Sub-atmospheric pressure is applied to the wound with a sealed dressing joined to a vacuum pump.
With so many pioneering treatments on offer, you no longer have to suffer in silence.