Lower Extremity Ulcers
Many different types of ulcers can occur on the lower extremities. The most common types are venous ulcers, arterial ulcers, and neuropathic ulcers. What are these, you ask? Venous ulcers are created when the valves of the veins of the legs are incompetent, and the blood does not flow back to the heart appropriately. It leads to elevated pressure in the legs and edema (swelling). The constant pressure on the soft tissues creates a wound that can be quite painful. The person affected can have very swollen legs and a wound that drains fluid. Patients who are at risk for these types of ulcers may have had varicose veins, struggle with obesity, or have had a blood clot (DVT) in the leg in the past. Without appropriate treatment, these wounds can be difficult to heal and may reoccur if therapy is discontinued. For venous ulcers, treatment usually consists of compression therapy and local wound care. For more advanced wounds, procedures such as grafting can help expedite the healing process.
Arterial ulcers usually result due to poor blood flow to the legs and feet. Peripheral vascular disease, smoking, and diabetes are medical conditions that can lead to the development of arterial ulcers. The area may look like a dark patch due to the lack of blood flow. Vascular studies or tests that check the arteries for blockages are helpful in determining if a consultation with a vascular surgeon would be helpful. Vascular surgeons or interventional radiologists can perform procedures that open the vessels. There are simple tests our providers can do to screen for these problems. Once blood flow has been reestablished, wound treatments are continued until the wound is closed. In severe circumstances, such as gangrene or spreading cellulitis, amputation of the affected area might be indicated. It is important to seek treatment for any wound to ensure that the limb, foot, or toes do not require a disabling amputation.
Neuropathic ulcers are common in diabetic patients. The patient may lose sensation, and this can lead to a wound developing without the patient feeling that something is irritating the skin. An example would be a shoe that creates friction on an area of the foot but the patient cannot feel it. Diabetics need to perform regular foot exams to ensure that there are not areas that need attention, as they cannot rely on how the foot feels to them. Also, diabetes can create a foot deformity called Charcot foot where the foot becomes misshapen due to inflammation and fractures. The foot can then be more susceptible to wounds due to improperly fitting shoes and a shift in the pressure contact points of the foot. No matter what caused the wound, treatments are available to reduce further disability, heal the wound, and promote function of the lower extremity. At Mobile Wound Care MD, our wound care team is proficient in treating large and hard-to-heal wounds. If you suffer from a lower extremity wound, contact us to discuss what treatments might be best for you.
By Dr. Leah Dill
Dr. Leah Dill, a native of Forestburg, Texas, earned her bachelor's degree in Biology from the University of North Texas. As a Doctor of Osteopathic Medicine at Total Wellness and Bariatrics, she is dedicated to providing holistic, whole-person care.
With extensive expertise in wound care, Dr. Dill specializes in chronic wounds and holds a certification from the National Alliance of Wound Care and Ostomy. She brings over 14 years of surgical experience to her practice, demonstrating tremendous compassion and commitment to her patients' total wellness.
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