What are leg ulcers?

Written by: Mr Ian Franklin
Published:
Edited by: Laura Burgess

Leg ulcers are wounds that form most commonly on the lower part of the leg around the ankle. They can be very painful, unpleasant and debilitating. There are many causes of a leg ulcer but by far the most common is faulty veins, either varicose veins or veins damaged by scarring from an old blood clot.


 

Are there any risk factors for leg ulcers?

Varicose veins are the main risk factor. Increasing age, obesity and poor mobility are also important. There are many other causes of leg ulcers including blocked arteries, blocked veins, faulty peripheral nerves, diabetes, infections, inflammation in skin/blood vessels and some skin cancers. It is very important as soon as an ulcer appears to determine what the underlying cause is. This invariably requires assessment by a vascular specialist to check the underlying circulation.
 

What is the treatment for leg ulcers?

Successful treatment of a leg ulcer requires an accurate diagnosis of the underlying cause with a specialist such as a vascular surgeon. Treatment by dressings and antibiotics alone is not enough. A Doppler ultrasound scan is vital to assess the underlying circulation and determine whether treatment is needed to correct faulty veins and sometimes arteries.

For many people, the ulcer is helped by applying compression bandaging. This can make the leg much more comfortable and promotes healing. Leg ulcers heal more quickly if, in addition to good compression bandaging, the underlying vein problem is treated. This can usually be done as an outpatient under local anaesthetic without admission to hospital.
 

Can the ulcer come back?

This depends on the cause of the ulcer. Venous leg ulcers (the commonest variety) are much less likely to come back if the veins which caused the problem are properly treated. Ulcers often come back if they are treated with dressings without identifying and treating the underlying cause.

By Mr Ian Franklin
Vascular surgery

Mr Ian Franklin is a London-based leading specialist in vascular and endovascular surgery. His specialist interests include varicose and thread veins, aesthetic phlebology, pelvic vein congestion, deep vein thrombosis, leg swelling, and leg ulcers. Ian Franklin was a NHS doctor for 23 years including 12 years as consultant vascular surgeon at Imperial College NHS Trust performing a full range of arterial, venous and emergency vascular surgery. He is now a full-time private venous specialist, practising in various locations across the capital. He introduced key minimally invasive treatments to the NHS and has written numerous scientific papers, book chapters and a surgical textbook. Mr Franklin is involved in the education and training of other specialists in modern vein techniques all over the world and is the programme director of the International Charing Cross Venous Course held in London every April. He is a former member of the Council of the Vascular Society of Great Britain and Ireland and served as chairman of the Circulation Foundation. He is President Elect of the Royal Society of Medicine Venous Forum. 

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