Chronic Leg Ulcers: Symptoms, Causes, Treatment

Not every leg ulcer is venous; arterial and venous problems can coexist. Persistent or atypical wounds need reassessment rather than repeated identical treatment.

Related reading: Diabetic foot and wound care.

An open wound may accompany swelling, pain, discharge or discoloration. Rest pain, a cold foot or black tissue raises concern about blood supply.

Venous hypertension or poor arterial supply are common causes. Neuropathy, pressure and inflammation may contribute; less common causes such as skin cancer require targeted exclusion.

Venous disease, previous clots, diabetes, smoking and limited mobility increase risk through different mechanisms. Glucose control alone does not replace assessment of leg arteries and veins.

Assessment examines the wound and circulation, using appropriate Doppler, ankle or toe-pressure measurements. Venous studies or biopsy may be needed for atypical or nonhealing wounds.

Suitable venous ulcers receive professionally selected compression after circulation assessment; arterial ulcers may require vascular intervention. Wound care, pain relief, nutrition and indicated infection treatment are individualized.

Infection, chronic pain, mobility problems and recurrence after healing can occur. Tissue-loss risk depends on the cause, circulation and timely treatment.

Follow the agreed activity, skin-care and swelling-management plan and avoid smoking. Do not independently apply strong compression or use irritating substances or repeated unnecessary antibiotics.