Is the strange sore on my leg a venous ulcer?
A venous ulcer – caused by underlying varicose veins.
This ulcer is an open wound or sore that takes a long time to heal, comes back again or doesn't heal at all. Leg ulcers have various causes, including varicose veins, blocked arteries and swollen legs from excess fluid around the ankles. Diabetes may make this condition worse. If you think you have a leg ulcer it is important to consult a vascular specialist.
What is a venous ulcer?
Venous ulcers occur due to poor blood circulation in the veins, causing increased pressure on the skin. They occur on the lower legs. The leg may be swollen and there may be other skin changes, such as eczema, itching and discolouration.
Venous ulcers are often not particularly painful, unless they are infected.
What does a venous ulcer look like?
A venous ulcer is an open wound with:
- An irregular shape
- Shallow depth
- A red base, sometimes covered with yellow tissue
- Swollen, discoloured or hardened skin
- Surrounding skin that looks dry and scaly
- Itchy skin.
Other ulcers include: arterial ulcers and diabetic ulcers
Arterial ulcers – caused by poor blood flow through the arteries. Will most often be found on the feet, heels or toes and are often painful, especially when they are infected.
Foot ulcers are more likely in people with diabetes. A diabetic ulcer is often difficult to heal because of underlying blood circulation issues, a complication of diabetes. If you have diabetes and a suspected foot ulcer, it is important to seek treatment early. See below for how a diabetic ulcer can progress without treatment or attention.
What does the path to treatment for a venous ulcer look like?
Because ulcers are distinctive open sores that don’t heal easily, you will most likely see your general practitioner (GP), community nurse, nurse specialist or nurse practitioner first. They will refer you to a vascular specialist but you can also refer yourself. The most important thing is to get on to treatment early.
Our vascular specialist will recommend treatment options, including prescribing antibiotics if there is an infection and an ultrasound scan to test the arteries and veins. Next, they will often refer you to our nurse clinics for wound dressing and maintenance.
Our experienced nurses take care of your venous ulcer
We assess, treat and offer advice for ulcers in our specialist nurse clinics. We clean and dress the ulcer in a sterile environment. Our nurses are available to answer questions about your ulcer and follow up to check on your progress. We will refer you back to your GP practice or to the community nurses once the ulcer is healing.
Wearing compression socks maybe recommended
Wearing compression socks often helps improve blood flow and can reduce swelling. This aids the healing process for an ulcer. Best worn when healed or nearly healed.
In some cases, surgery may be necessary to improve blood flow or remove dead tissue from an ulcer. Skin grafts may be an option for large ulcers or those that don’t respond to other treatments.
What can you do to help healing and prevent an ulcer recurring?
While regular exercise may be difficult at first, adopting a healthier lifestyle can improve the healing process. This includes gentle exercise, you might do seated or floor exercises at first and progress to walking. Eating a balanced diet and following instructions on living with conditions like diabetes also help ulcers to heal.
It is important to seek advice early whenever you suspect you have an ulcer. And once your ulcer has healed we recommend regular check ups.
Helpful information on how much time varicose vein treatment takes
In response to the most frequently asked question when patients call us, we break down the time varicose vein treatment takes. We say on the day of your treatment allow an hour an a half, as that will be enough time for the consent process, treatment and recovery.
You need an ultrasound scan before treatment
Before varicose vein treatment, we ask patients to have an ultrasound scan. We will arrange an ultrasound scan for you. This means when you see the vascular specialist they are armed with a map of your veins and can advise on treatment immediately. An ultrasound scan usually takes between 30 and 60 minutes, depending on whether you need one or two legs treated, how severe your varicose veins are or if your varicose veins are in another part of the body, for example, the pelvis.
How much time does the ultrasound scan take? It takes: 30-60 minutes.
Next is your consultation with the vascular specialist or vascular specialist nurse
This appointment will typically be for about 10-15 minutes. Many patients prefer to talk with the vascular specialist or vascular nurse specialist over the phone. You will need to provide them with photos of your varicose veins for this. The phone consultation takes the same amount of time as an in-person consultation.
You can complete our online form, too. The vascular specialist or vascular specialist nurse will evaluate the condition of your varicose veins and discuss treatment options, if necessary.
How much time does the consultation take? It takes: 10-15 minutes.
Treatment day: your consent and pre-procedure information
Our nurse will call you a couple of days before treatment. On the day, the nurse will prepare you for your treatment, check your personal details and give you a gown to put on. Next, the vascular specialist will explain the procedure again, answer any questions, talk about the risks and benefits of treatment and get your signed consent to go ahead.
How much time does the consent take? It takes: 15 minutes.
How much time varicose vein treatment takes
How much time varicose vein treatment takes depends on the type of treatment:
VenaSeal medical adhesive
This procedure involves sending droplets of medical glue down a catheter inserted into the vein to seal off the vein so it will eventually fade. We predominantly use VenaSeal for our varicose vein treatments.
How much time does time does the VenaSeal procedure take? It takes = 15 minutes per leg (other areas of the body take longer).
Endovenous Laser Treatment (EVLT) or Radiofrequency Ablation (RFA)
EVLT/RFA typically takes about 45 to 60 minutes. This minimally invasive procedure involves inserting a laser fibre into the vein to seal it shut.
How much time does time does EVLT/RFA treatment take? It takes: 45-60 minutes.
Sclerotherapy
Sclerotherapy involves injecting a solution (sclerosant) into the smaller varicose veins to make them to close. This precise treatment is most often performed immediately after VenaSeal treatment. It usually takes about 20-30 minutes.
How much time does sclerotherapy treatment take? It takes: 20-30 minutes, depending on how many smaller varicose veins need treating.
When can you leave to go home after varicose vein treatment?
After the procedure, you will be fitted with thigh-high compression stockings, then patients are monitored for about 20 minutes but can walk out of the treatment room. It is okay to go home after 20 minutes. We recommend someone drive you home.
How much time does observation take? It takes: 20 minutes.
How long is the at-home recovery time for varicose vein treatment?
Because the treatment is minimally invasive patients can resume normal activities within a couple of days. Our nurse will call you a day or so after treatment to check on you. Patients may experience some bruising, swelling and discomfort, which typically improves within a few days to a week.
How much time does at-home recovery take? It takes: 2-3 days.
How long is the follow-up appointment for varicose vein treatment?
Most often our nurse will check in on you again at the six-week mark. An appointment to call you will be made before you leave the clinic. If you have any concerns before this, please call our nurses. You can also ask for the vascular specialist to contact you for a follow-up appointment. These appointments are very quick so we recommend a phone call follow up.
How much time does the follow-up appointment take? It takes: 5-10 minutes.
Recovery, including the resolution of swelling and bruising, can take several weeks to months.
Note: these are based the times it usually takes. This may vary between patients.