A wound that won't heal - an ulcer - on your lower extremities can severely impact your mobility.
There are three common types of leg and foot ulcers. Each one has a unique treatment program to effectively heal the wound and keep it from returning.
Venous stasis ulcers
Venous ulcers are located below the knee and are primarily found on the inner part of the leg, just above the ankle. These ulcers are common in patients who have a history of leg swelling, varicose veins, or a history of blood clots in either the superficial or the deep veins of the legs.
Venous ulcers affect 500,000 to 600,000 people in the United States every year and account for 80 to 90% of all leg ulcers.
Arterial ulcers are usually located on the feet and often occur on the heels, tips of toes, between the toes where the toes rub against one another or anywhere the bones may protrude and rub against bed sheets, socks or shoes.
Arterial ulcers are typically very painful, especially at night. The patient may instinctively dangle his/her foot over the side of the bed to get pain relief. The patient usually has prior knowledge of poor circulation in the legs and may have an accompanying disorder,
Neurotrophic ulcers are usually located at increased pressure points on the bottom of the feet. However, neurotrophic ulcers related to trauma can occur anywhere on the foot. They occur primarily in people with diabetes, although they can affect anyone who has an impaired sensation of the feet.
Due to circulatory issues, it's easy to see why people with diabetes (link to diabetes page) are more prone to foot ulcers than other patients. If you have diabetes, remember to inspect your feet daily, wear appropriate footwear and never walk barefoot.
Treatment and Prevention
Because the treatments vary based on type and severity of ulcer, it's critical to consult with your physician before initating any self-treatment. Your treatment may include a variety of options described below.
Treatment options for all ulcers may include:
- Antibiotics, if an infection is present
- Anti-platelet or anti-clotting medications to prevent a blood clot
- Topical wound care therapies
- Compression garments
- Prosthetics or orthotics, available to restore or enhance normal lifestyle function
Venous ulcers are treated with compression of the leg to minimize edema or swelling. Types of dressings include:
- Moist to moist dressings
- Alginate dressings
- Collagen wound dressings
- Debriding agents
- Antimicrobial dressings
- Composite dressings
- Synthetic skin substitutes
Arterial ulcer treatments vary, depending on the severity of the arterial disease. The goals for arterial ulcer treatment include:
- Providing adequate protection of the surface of the skin
- Preventing new ulcers
- Removing contact irritation to the existing ulcer
- Monitoring signs and symptoms of infection that may involve the soft tissues or bone
Neurotrophic ulcer treatment includes avoiding pressure and weight-bearing on the affected leg. Frequently, special shoes or orthotic devices must be worn.
Controlling risk factors can help you prevent ulcers from developing or getting worse. Here are some ways to reduce your risk factors:
- Quit smoking
- Manage your blood pressure
- Control your blood cholesterol and triglyceride levels by making dietary changes and taking medications as prescribe
- Limit your intake of sodium
- Manage your diabetes and other health conditions, if applicable
- Exercise - start a walking program after speaking with your doctor
- Lose weight if you are overweight
- Ask your doctor about aspirin therapy to prevent blood clots
Caring for Ulcers at Home
There are some simple ways that you can care for your wounds at home.
- Keep the wound clean
- Change the dressing as directed
- Take prescribed medications as directed
- Drink plenty of fluids
- Follow a healthy diet, as recommended, including eating plenty of fruits and vegetables
- Exercise regularly, as directed by a physician
- Wear appropriate shoes
- Wear compression wraps, if appropriate, as directed
With the help of your physician, focused care and proper foot and ankle products, you can effectively treat ulcers and make sure they don't come back. Which means you can get back to everyday activities without pain.