Have you recently noticed a cut or scrape on your leg that seems to have been there for a while? Are you starting to wonder if it will ever go away? You may have developed an ulcer—a wound that won’t heal without medical intervention. Here’s how to know if your cut or scrape is more than just a surface injury.
What Exactly is an Ulcer?
Everyone gets wounds at some point in their lives: they are just injuries that damage your skin, exposing the tissue that lies beneath. When your body is working properly, these wounds are no big deal. They usually heal on their own, although topical creams can speed up your recovery time.
Sometimes, however, that’s not the case. If your injury hasn’t mostly healed within a month, chances are you have a non-healing wound (ulcer.) This is especially likely if you have a condition, like varicose veins or diabetes, that has compromised your blood circulation.
If you do have an ulcer, it’s a big problem: in fact, if you don’t seek treatment for ulcers, you could end up with serious medical complications. You could even lose your affected limb.
So, aside from timing, how can you know if you have a non-healing wound? Chances are, you’ll notice other symptoms at the site of your wound, including:
You may also develop a fever with your infection.
How Can I Treat My Ulcer?
If you suspect you’ve got a non-healing wound, don’t panic: your vein specialists can help. We can make sure that your wound is being cared for, with debridement (removing dead or infected tissue), proper dressings to keep the area clean and protected, pressure, and applicable medications. We will also work to address any underlying vascular issues that may have contributed to the problem.
The key to recovering from ulcers is to seek medical help as soon as you identify a problem. So, if you have compromised circulation, pay special attention to any cuts or nicks on your body. And if you notice any ulcer symptoms, go see your vein specialist right away.
If you have untreated vascular disease, you could develop leg ulcers. These open sores often develop just above your ankle, on the inside of your leg. But, what causes them to develop? When your veins aren’t functioning well—as is the case if you’ve got varicose veins —the pressure inside those veins can build up rapidly. And, if that pressure isn’t relieved, it can damage your skin, leaving you with open sores. Plus, once those sores develop, they are slower to heal. Why? The answer lies in your circulation problems. Without getting enough oxygen-rich blood, the skin on your legs can’t regenerate as well as it should. And this can make it harder for wounds to heal. Which is why, as Houston vein specialists, we’re very excited about a newly developed wound treatment. Want to hear the coolest part? It’s developed from blood!
Using Blood to Speed Up Wound Healing
According to a study in Advances in Skin and Wound Care, researchers at the University of Manchester have developed a gel, made from blood, that’s speeding up healing times for ulcers. Typically, these ulcers take at least three months to heal but, studies show that for at least 14% of patients, wounds are still a problem one whole year later. And, for others, the wounds just don’t heal, making it necessary to amputate.
For all these reasons, a new, faster wound treatment is a very big deal. So, how does the new gel work? Doctors take a little more than a teaspoon of your own blood and spin it around in a piece of equipment called a centrifuge.
While your blood spins, your plasma gets separated from the other parts of your blood. Plasma is rich in platelets, and platelet are full of ‘growth factors’ that boost your body’s healing. Once your plasma has been isolated, it gets mixed with a few other compounds, and, in about 30 seconds, it takes on a gel form. Your doctor puts that gel on your wound right away, and then covers the area with a bandage to help your wound heal faster.
But, you may be wondering, just how effective is the gel? Forty-eight percent of patients treated with gel had full wound healing, compared to 30% of patients treated with other methods. And, even more exciting news: the healing time was cut in half! Wounds had shrunk by 50% in 21 days for patients using the gel. Patients not using the gel had to wait 42 days to get that same result.
While the gel is still being studied, the results are certainly exciting. We can’t wait to learn more about this therapy, which harnesses your own body’s potential to self-heal!
FeelTect, an Irish startup, has a special grant to develop ‘Tight Alright’ technology. It’s intended for use in a medical device that senses pressure and treats venous leg ulcers. To understand why and how it will work, we must first explore what causes venous leg ulcers.
What are Venous Leg Ulcers and Why Do They Form?
Venous leg ulcers are chronic wounds that develop because of venous insufficiency, a condition in which your body can’t circulate blood from your lower limbs. Venous insufficiency sets in when tiny valves in your veins stop working well. Instead of forcing blood back up towards the heart, it pools your legs. Then, your veins get stretched out and fluid builds up in your lower limbs.
You may be at risk for venous leg ulcers if your:
Body Mass Index (BMI) is elevated
Living a sedentary lifestyle
Have high blood pressure,
Veins are insufficient, you have deep vein thrombosis (DVT) and/or a family history of these conditions.
Treating Venous Leg Ulcers
One of the first treatments for these kinds of ulcers is compression therapy. The pressure placed on the veins in your lower legs can help get pooling blood out of the area, taking the pressure off your bulging veins and making the excess fluid less likely to contribute to existing ulcers, or to allow new ones to develop.
Still compression therapy isn’t perfect. If doctors apply too much pressure, it can cut off all circulation to your limbs. Not enough pressure, and the treatment will be wholly ineffective. And, since compression devices cover the area being treated, it can be tough for doctors to determine just how much pressure is being delivered to your veins.
The Tight Alright device is intended to work in conjunction with compression therapy. Using wireless technology, the device measures and monitors the amount of pressure being delivered to your leg beneath the compression bandages.
When vein specialists are armed with this kind of information, they can easily adjust compression bandages to appropriate levels, keeping you safe while speeding up your healing times. As vein specialists in the Houston area, we will be watching this and other developing technology, so we can always deliver the most up-to-date care for all our patients who are living with vein disease.
An ulcer is an open sore that does not heal or is recurrent. Ulcers can develop on your lower legs, most often around the ankles, or wherever there is consistent pressure on the foot. If they are small, they can be quickly treated, and we can keep them from returning. But if an ulcer is left to grow deeper into the skin tissue, or if it becomes infected, treatment will likely be drastic–and expensive.
How does a lower leg ulcer develop? Are there different kinds of ulcers? Read on to get a better understanding of ulcers, their treatment options and the best methods of prevention.
The most common ulcers of the lower leg are venous ulcers. These occur when veins in the leg do not return blood back to the heart, a condition called chronic venous insufficiency. The unreturned blood pools in the leg tissue, causing swelling and low oxygen levels. As a result, a simple wound is unable to heal and becomes larger, leading to venous stasis ulceration.
Venous ulcers range from being painless to quite painful over time. They usually develop just above the ankle and on the inner leg. A telling sign of a venous ulcer is a brown, rust-colored pigmentation. Once it develops, the ulcer is red in color and possibly tinted with yellow fibrous tissue. A green or yellow discharge is also possible if it is infected. The surrounding skin might be warm and appear shiny and tight.
Venous ulcers usually affect older patients with a history of vein disease, varicose veins, and blood clotting. The fundamental cause is poor circulation, which can be brought on a number of ways, from atherosclerosis, obesity, heart disease, or smoking. Genetics, certain medications, and simply standing or sitting for too long on a daily basis can also factor in.
Diabetic and Arterial Ulcers
Though much less common, diabetic (neurotrophic) and arterial (ischemic) ulcers can be equally dangerous if left untreated. Their cause, appearance, location, and treatment are different from venous ulcers, so it is important to have an expert diagnose them. If left untreated and infected, they can lead to amputation.
Diabetic or neurotrophic ulcers are a result of an impaired sensation in the feet and decrease in wound healing, usually from diabetic nerve damage. They occur at pressure points on the bottom of the feet or wherever a wound has formed. Because of the lack of sensation, the patient is often unaware of them. It is important that diabetic patients inspect their feet daily. They can be pink/red or brown/black with a punched out or calloused/cracked border.
Arterial or ischemic ulcers on the other hand are extremely painful and caused by arterial disease, like atherosclerosis and peripheral arterial disease (PAD). They are unable to heal because of lack of blood in the tissue due to poor circulation. They often develop on the feet, especially the toes, and occasionally on the ankles. Their appearance is yellow, brown, gray, or black. They usually do not bleed. Like diabetic ulcers, the surrounding skin appears punched out. The pain is greatest at night and can be relieved by dangling the legs off the bed.
Treatments and Prevention
Venous ulcers can be treated in a variety of ways, most commonly with compression treatments. Lifting the legs above the heart whenever possible also helps. It is important to treat the underlying cause of the ulcer, too, to prevent recurrence. For venous ulcers, this includes closure of the abnormal veins causing venous insufficiency with ablation therapy.
For arterial ulcers, a proper diagnosis must be made to determine the potential for wound healing. Compression therapy does not work for arterial ulcers and can make them worse. Treatments involve attempting to re-vascularize the leg through endovascular therapy. Treatment for neuropathic ulcers include debridement or removal of infected tissue, avoiding pressure on the ulcerated leg, and special shoes to prevent contact irritation.
Ulcers of the lower leg can be prevented by checking your ankles and legs daily for early signs of ulceration. This is key to getting the preventative treatment you need. Taking daily walks, eating healthier, quitting smoking, and anything that improves overall circulation will go a long way in preventing ulcers and venous/heart conditions.
How to Treat Your Ulcer at the Source
Whether you need an accurate diagnosis for your lower leg ulcer, or need treatment, Texas Endovascular has the vein expertise necessary to help. Schedule an appointment with us today and we’ll get you on the path to recovery.
Lower-leg ulcers are a serious complication that can develop with untreated vein disease. In order to protect yourself from ulcers, it’s important to understand the risk factors that increase your likelihood of developing this type of wound.
Risk factors for CVD
One of the main reasons people develop ulcers is because of CVD, chronic venous disease. And while we don’t always know why people develop CVD, some contributing factors include:
Being a woman
On the job risks, like all day standing or sitting.
Any one of these factors can increase your risk of compromised blood flow, varicose veins, and, eventually, chronic venous disease. This, in turn, can make you more likely to develop an ulcer on your lower legs.
Warning Signs for Lower Leg Ulcers
Of course, it’s important to remember that not all people who have CVD will develop ulcers. With people who have CVD, you can watch for certain signs that may indicate an ulcer will soon form:
Skin changes: CVD patients with varicose veins, thickened skin or venous eczema (also known as varicose eczema, symptoms include itchy, flaky, dry, crusty and/or swollen skin) are more likely to develop an ulcer.
Edema: Studies show that edema is present in about 90% of patients with lower leg ulcers. Edema, or swelling, occurs when you form more lymph fluid than can be drained, or when your lymph material doesn’t flow well. This leads to a build-up of the fluid that results in swelling in your lower legs.
How to Prevent Venous Ulcers
Whether or not you’re displaying ulcer warning signs, you can take measures to prevent this devastating complication. These steps include:
Avoiding weight gain
Eating a balanced diet
Regularly moisturizing your skin
Avoid cigarettes or any kind of smoking
Moving every 30 minutes to avoid long periods of sitting or standing
If you are concerned about developing ulcers, or already have an ulcer in need of attention, it is important to see your Houston area vein specialist right away. Any delay could pose a serious risk to your limbs, as well as your overall health.
When you have vein disease, you may experience a wide range of symptoms, from tired heavy legs to changes in the appearance of your skin. One potential skin change you may experience is the development of a venous skin ulcer (a sore on your leg that’s hard to heal, usually because your circulation isn’t working well.) While ulcers can be difficult to treat, a new study is now suggesting that exercise, in combination with compression therapy, can help ulcers heal faster!
According to research published in JAMA Dermatology, ulcer patients who tried compression therapy and exercise healed quicker than those who only used compression therapy. Compression therapy, usually in the form of socks or stockings, helps heal leg ulcers by directing more blood flow to your legs. In this new study, researchers reviewed clinical information for 190 patients, and found that healing rates improved by 14% when patients were prescribed compression therapy and exercise, as compared to compression therapy alone. For the purposes of this review, the exercise included walking and ankle exercises, both of which improve blood flow and strengthen calf muscles. Strong calf muscles can help manage the symptoms of vein disease because, when they contract properly, those muscles can help give blood the push it needs to make its way back to your heart.
As Houston vein specialists, we are dedicated to improving vein health and helping people heal from vein disease. With that goal in mind, we dedicate frequent Monday blog posts to exercises that may help improve your vein health. Given the findings in this study, today’s post will highlight ankle exercises you can do from anywhere, and without any equipment. As always, consult with your doctor before beginning any new exercise plan!
Five Ankle Strengthening Exercises for Improved Circulation
Standing on one foot: Begin by just standing on one leg at a time, and holding the position for as long as you can. Once that becomes fairly easy to pull off, try doing the same thing, but with your eyes closed.
Standing calf raises: Lift yourself up on your toes for 15 reps, taking a brief pause between sets. If you are ready for more of a challenge, do the exercise on one leg at a time, or hold a light set of weights while you do the raises
Heel walks: Lift your toes and forefoot off the ground. Walk back and forth across the room, balancing on your heels.
Hop Around: Stand on your right leg. Hop forward, sideways and backward up to 30 repetitions, if you are ready for that kind of challenge. Then switch legs and repeat the moves on your left foot.
Skater jumps: Start in a standing position on your left leg. Propel yourself to the right using the muscles in your left glute, and land on your right leg with a bent knee. Jump back to the left side, using the muscles in your right glute to move you over.
When you suffer from chronic vein disease, you are vulnerable to venous leg ulcers: hard-to-heal sores that develop on your legs due to a combination of damaged capillaries and lymphatic ducts, and lack of oxygen in your lower legs. Once they develop, ulcers are hard to heal because, once again, of the shortage of oxygen reaching your lower limbs.
Fortunately, managing your vein disease with doctor-approved exercise can help protect you from developing ulcers. And, if ulcers have already formed, new evidence suggests that certain exercises may speed up your healing process!
Can Calf Raises Cure Venous Leg Ulcers?
According to Dr. Laura Bolton, a member of the Wounds advisory board, evidence suggests that structured exercise training (SET) can help speed up the healing process for both venous leg wounds and diabetic foot ulcers. Chief among those exercises included in the SET program? Calf raises, thanks to their ability to get the heart pumping and improve circulation to the lower extremities.
In her study, 77% of patients with venous leg ulcers had completely healed after a 12-week progressive exercise program; only 53% of non-exercisers enjoyed the same result. When it came to diabetic foot wounds, individuals who exercised for just 30 of the 96-day trial window saw a dramatic result in the size of their ulcers.
In revealing her findings, Bolton said: “This suggests that the more patients engage in calf muscle exercise, the more and earlier they improve their chronic VLU or DFU healing…[This could lead to saving] limbs and lives of patients. ”
Calf-Raise Routine for Improved Circulation
While no vein disease patient should engage in a new exercise routine without a doctor’s supervision, it is a good idea to discuss your physical activity once you’ve been diagnosed with vein health issues. Ask your doctor if it is safe to try this calf-raise routine, and you may just enjoy preventative or healing health benefits!
Standing Calf Raises
Position yourself on a staircase, with your hands resting against a wall or a sturdy object for balance and your heels hanging off the back edge of the stair. Raise your heels a few inches above the edge of the step so that you’re on your tiptoes. Hold the position for a moment, and then lower your heels below the platform, feeling a stretch in your calf muscles. That’s one rep; aim for three sets of 10-15 reps each. Please note that you may have to build up to that level of performance.
When you have venous insufficiency (or VI, a condition in which your veins fail to circulate blood properly, especially to your lower extremities), troubling symptoms may start to develop. One common side effect of VI is edema (swelling) of the lower legs. And when you experience edema for an extended period of time, you are more susceptible to venous ulcers, open wounds that develop on your legs as a result of increased vein pressure due to your malfunctioning venous valves.
While ulcers can be frightening, there are several ways in which we can treat these sores. First and foremost, it’s important to address the underlying cause of the problem–your venous insufficiency and edema.
To help control edema, we recommend that patients wear compression stockings; the pressure will help encourage pooling blood to flow out of your legs and back up to your heart, reducing the swelling you experience in your legs. Elevating your legs can help as well: if you put your feet up above the level of your heart, it will also encourage pooling blood to leave your legs.
But there’s one more way we can control edema and VI, reducing your risk of venous ulcers: exercise!
Exercise as a Form of Ulcer Prevention
As long as your doctor has cleared you for physical activity, certain forms of exercise can help manage VI, edema and ulcers. Exercises that are particularly effective include:
Ankle flexions (point your toes forward, away from the body, then flex them, pulling the toes toward your shin). The exercise is even more effective if performed while standing, or with the addition of a resistance band will further enhance the effects.
Brisk walking intervals, scattered throughout the day, will strengthen your calf muscle, helping it contract and push blood out of your lower legs.
Treadmill walking, especially at an incline, if this is possible for you, will further strengthen your calf muscles. If you aren’t up to treadmill walking, you can get similar benefits from rocking in a rocking chair, pushing off the ground with your feet to rock.
Of course, the best way to prevent ulcers is to maintain ideal vein health. If you start to notice any signs of VI or edema, come in and schedule a diagnostic vein scan. That way, we can stay on top of your vein health before more serious problems set in.