Leg ulcers are open wounds that are hard to heal. That's why treating leg ulcers is so tricky. And why new treatment studies and technology are so important. Today, we'll explore two of those factors. The first is a new study related to the timing of treating leg ulcers. The second is a new technology for treating leg ulcers. Launched by FeelTect, an Irish startup, this ‘Tight Alright’ technology is intended for use in a new medical device. It will sense pressure to help with detecting and treating leg ulcers. And the third is a new smart bandage, that can wirelessly monitor wound healing, so you can keep an ulcer covered while making sure it's progressing. But to understand why and how these treatments will work, we must first explore what causes venous leg ulcers.
An ulcer is a deep wound. There are different types of ulcers that can form inside or outside of your body. They develop when healthy tissue erodes from a certain area of your body. And there are many reasons why that might happen.
Different types of ulcers include arterial ulcers, which develop on your skin because of problems with lack of blood flow. You may develop mouth ulcers, or canker sores, which form for many different reasons. Another type of ulcer can form on the genitals, or in the stomach or small intestine. (The latter are called peptic ulcers.)
Finally, you may develop venous ulcers on the skin of your lower legs. Also called varicose or stasis leg ulcers, these are the types of ulcers we'll explore in this post.
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 you have a high Body Mass Index (BMI). Living a sedentary lifestyle can increase your risk. As can high blood pressure. Finally, if your veins are insufficient, you have deep vein thrombosis (DVT) and/or a family history of these conditions, you're more likely to develop an ulcer.
Once you know your risk factors for ulcers, we want you to look for the early symptoms. When an ulcer is just beginning to develop, you may notice itchy, tingly, or swollen skin, The affected area may hurt, and the surrounding skin can change colors or harden.
When ulcers develop on your lower leg, your calf muscle may change it's appearance, looking like a bowling pin turned upside down. (This condition is called lipodermatosclerosis.) Later, as the condition progresses, you may also notice a sore that doesn't heal, even after weeks pass. It may smell or give off discharge. And the appearance of the skin surrounding the sore can also be impacted. Clearly, symptoms get progressively worse without treatment. So, seeking early intervention is the best way to protect your limb health.
Compression therapy is a great first treatment for leg ulcers. 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.
Now, 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.
Of course, bandages also cover wounds. But removing them to check on healing can irritate your ulcer. To help combat this problem, researchers from the National University of Singapore developed a wearable sensor that detects wound temperature, pH, bacteria type and inflammatory factors. Best of all? It can do so in 15 minutes, wirelessly, so we can be sure your wound is healing well without disturbing the protective dressing.
Clearly, compression therapy isn't perfect. And while new technology can help, changing treatment protocols may make a bigger difference. According to a new study in JAMA Surgery, compression therapy may not be the best first course of action.
In a clinical trial, 450 leg ulcer patients were instead treated with early interventions. And the results were astounding: patients healed faster. And had a lower risk of repeat problems with ulcers. Their outcomes were better than for those patients who first tried treating leg ulcers with compression therapy. And then turned to other interventions.
Of course, new treatment options keep popping up. In a recent study from the Journal of Experimental Dermatology researchers combined compression therapy with topical cannabinoids. (If you don't know, cannabinoids are chemical compounds that naturally occur in cannabis plants. They range from non-psychoactive CBD to federally controlled-substances such as THC. And researchers believe they may offer medicinal properties.)
For this study, 14 elderly patients with non-healing leg ulcers received topical cannabis-based treatments, as well as compression bandages. At the end of the study period, 11 of those subjects reported full wound closure. Now, this is an exciting development. But more research, and larger studies, are needed before we can widely recommend this treatment option.
Additionally, some research suggests that select forms of bacteria could actually promote wound healing. To date, however, there have not been clinical trials to test this theory, so it's likely not to be an option for quite some time.
As vein specialists in the Houston and Dallas area, we're watching all the developments when it comes to treating leg ulcers. That way we can always deliver the most up-to-date care for our patients living with vein disease. Ready to explore your leg ulcer treatment options? Schedule an appointmentSchedule an appointmentSchedule an appointment with our specialists today!
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