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.