2023-08-24 22:56:07
Definition: what is a leg ulcer?
Like all skin ulcers, a leg ulcer is a wound that does not heal. It is more or less deep and painful.
The leg ulcer is mainly due to a vascular cause (venous and/or arterial). This disease affects regarding 1% of the general population. Women following menopause are more affected.
Leg ulceration: a skin sore that does not heal
leg ulcer does not heal spontaneously, hospital care is necessary to stop its insidious development. The treatment targets the cause of the ulcer and uses some different innovative or proven techniques to relieve the symptoms.
How to recognize the start of a leg ulcer?
The ulcer can be limited to the surface of the epidermis or sometimes sink through the dermis, the hypodermis and can sometimes extend to the bone.
In the event of a wound that does not heal spontaneously (or even worsens) in the lower limbs, it is best to consult a doctor. It might indeed be an ulcer, especially if you suffer from a vascular disease and in particular from venous insufficiency.
What causes a leg ulcer?
The leg ulcer can have a venous or arterial origin. It can also be the consequence of necrotic angiodermatitis. It appears spontaneously or as a result of trauma or skin damage (even minimal).
Venous ulcer (varicose ulcer)
L’venous ulcer is the consequence of a venous insufficiency. It is a complication of a phlebitis or of varices.
Arterial ulcer
The ulcer of arterial origin can occur in a context:
– d’obliterating arteriopathy of the lower limbs (SLOW) ;
– medical examinations such as arteriography or acoronary angiography. These medical observations can lead to the detachment of fragments of cholesterol plaques which are deposited on the wall of the arteries and occlude the arteries of small calibers (microcirculatory origin).
Necrotic angiodermatitis
This type of ulcer affects the elderly more particularly in the event of arterial hypertension and/or diabetes.
What are the symptoms of leg ulcer?
An ulcer can present in different ways:
– venous ulcer usually develops around the ankle on an area that has varicose veins and spider veins. Then, a single, large, painless wound will appear. The bottom of the ulcer is yellow or red in color. The area around the ulcer may be swollen and tan in color.
– Arterial ulcer may result in the appearance of one or more lesions. These sores are painful, rounded and hollow in shape. The bottom of the ulcer is yellow, red or black (necrosis). The skin around the ulcer is smooth, hairless, white and cold.
– In case of’necrotic angiodermatitis, the ulcer appears as a small, shallow purple patch with jagged edges on the front of the leg. It is very painful. It may become covered with a black crust (necrosis). Around the ulcer, the skin is also purple (called purpuric) or inflamed (red, swollen and painful).
Other general manifestations may present as fatiguea deterioration of general condition or even thefever (sign of gravity).
What are the different stages of a leg ulcer?
The leg ulcer is a skin wound that evolves in several stages:
- The stage of necrosis: this is the first phase of the ulcer as soon as it appears. The wound is then covered with a brown or black, dry tissue. Healing is then slowed down by the necrotic debris. Healing is made possible by favoring the elimination of this debris by mechanical cleaning care or with the aid of dressings. If left untreated, worsening necrosis can lead to multiple complications.
- The fibrous stage : thanks to the treatment of the wound, it regains vitality and is covered with a yellowish coating. Nevertheless, at this stage the payroll is colonized by many germs, which can lead to infection. There may be a sometimes abundant serous exudate.
- The budding stage: this phase signals the healing process. A red fabric is put in place. Serous exudate may be moderate.
- The stage of epidermization: The epidermis gradually regains its initial appearance. The exudates are weak.
Is a leg ulcer dangerous? Can we die?
Skin ulcers lead to many complications such as:
- a microbial superinfection of the wound ;
- a eastthat is to say infection of the bone (especially if the ulcer is digging);
- of the joint stiffness (ankylosis of the leg);
- skin disorders around the wound such aseczema or one erysipelas ;
- a mutation in cancerous lesion ;
- general disorders: generalized infection (sepsis), anemia or malnutrition, a tetanus (if the patient is not up to date with his vaccination). Sepsis can potentially lead to death if left untreated;
- a hemorrhage in the context of venous ulcers with varicose vein wound;
- psychological complications due to the limitation of autonomy, the negative impact on the quality of life and self-image…
Leg ulcer: which examinations?
L’physical examination of the physician guides the diagnosis. L’arteriovenous doppler ultrasound of the lower limbs then makes it possible to observe the condition and the blood flow in the veins and arteries.
In the event of obliterating arteriopathy of the lower limbs (PAD), a arteriography (or CT angiography) is performed.
It is also advisable to check the good oxygenation of the tissues by a transcutaneous oximetry.
What are the treatments for leg ulcers?
Treatment of the cause is essential to overcome the leg ulcer (and avoid relapses).
Local care with dressings is performed by an experienced health professional. Depending on the stage of healing, skin grafts can be performed.
- In case of venous involvement, we focus on raising the lower limbs and wearing compression stockings. Sometimes varicose vein surgery is indicated.
- In case of arterial involvement, revascularization surgery (bypass, dilation) is often indicated associated with the correction of cardiovascular risk factors.
- In the case of necrotic angiodermatitis, hospitalization is often necessary for the treatment of cutaneous signs, stabilization of blood pressure and diabetes.
1692923115
#Leg #ulcer #symptoms #treatments
