Vascular ulcers are ulcerations that are found mostly in the leg region. Read this article to know more about the problems caused by vascular ulcers.
Vascular ulcers are chronic conditions that might affect the health of an individual. There might be open wounds in most of the patients. It can be accompanied by swelling and pain. The prime responsibility of veins in the leg is to send the blood back to the heart so that they enter the circulatory system for the system to function well. If there is any problem associated with the backflow of blood, it might result in an increased pressure level in the legs. This will make the skin more susceptible to damage. It can also result in more hardened skin that becomes very hard to heal in the later stages.
Vascular ulcers are classified into four types depending on appearance, location, and associated pain.
Arterial Ulcers: It is located on the dorsal region of the foot and toes. In the initial stages, it might appear as an irregular lesion. It will later progress into well-defined lesions. The base of the ulcer seems to be unhealthy, along with the granulation tissue. It appears to be grayish. Bleeding is noticed to a certain extent. The affected area would be pale, hairless, and ischemia might be seen.
Neurotrophic Ulcers: A punched-out lesion characterizes it. It often occurs over the pressure points. In the majority of the cases, the affected tissue will be surrounded by inflammatory tissue. If the affected site is disturbed, severe bleeding might be seen. This might result in neuropathic conditions. But, in general, patients with neuropathic ulcers do not experience any severe pain.
Venous Ulcers: Venous ulcer is a type of ulcer that occurs in the legs. It causes soreness in the skin. It is usually due to the poor circulation of blood to the legs. It takes a very long time to heal. The duration taken for healing might vary from many weeks to years. In some patients, it causes severe breakage in the lining of the skin. If it is untreated, it can lead to severe complications. So, it is essential to treat venous ulcers as soon as possible. It is often accompanied by a certain degree of pain.
Diabetic Ulcers: Several factors can cause diabetic ulcers. A neuropathic state is seen in patients affected by severe ulcers. There will be a loss of sensation in the affected region. Coordination between the muscles of the leg will be lost.
The early signs of vascular ulcers are:
Dark red, brown, purple, and hardened skin. It is a sign of blood pooling.
Leg swelling, cramping, and heaviness.
Tingling and itching.
The common signs and symptoms of vascular ulcers include:
Unevenly shaped borders.
Shallow sore with a red base, sometimes it is covered by yellow tissue.
Surrounding skin may be tight, discolored, shiny, hot, or warm.
If the sore gets infected, it may have a foul odor, and pus may drain from the wound.
The most common risk factors of vascular Ulcers are,
History of blood clots in the legs.
Being female or being tall.
Standing or sitting for an extended period (usually during work).
Blockage of the lymph vessels, which leads to fluid build-up in the legs.
Family history of vascular insufficiency.
Fracture of an extended bone in the leg.
Severe injuries like muscle damage or burns.
You will require a clinical examination by a doctor for vascular ulcers. The history of the patient and related medical history will be recorded with importance. If the patient has diabetes, then it would take a longer time for the ulcers to heal. Your doctor will recommend you go for a computed tomography scan (CT scan) or an X-ray.
Computed Tomography Scan (CT Scan): Computed tomography is a diagnostic procedure that allows doctors to visualize internal organs and structures. This procedure takes help from X-ray imaging techniques to produce images of bones, tissues, and other organs. It is known to be more precise than X-ray techniques. The computed tomography scans are performed in hospitals or scan centers. The patients and doctors have to follow many precautionary measures while performing this scanning procedure. You will be asked to wear specific gowns when the scan is taken. All the other jewelry and objects would not be allowed during this technique. This technique is beneficial for identifying the bleeding site in tumors. The only problem in the computed tomography scan is the risk of excessive radiation. Some patients are known to be affected by biological reactions. If you are taking any medication for diabetes, you should inform your doctor beforehand.
Angiography: Angiography is the best procedure to visualize the lower part of the body. In addition to this, magnetic resonance angiography (MRA) is also beneficial in identifying problems of the lower limbs.
Doppler Duplex Scanning: Doppler duplex scanning is a method that is used to find the venus reflux. It is a technique-sensitive procedure. If there are small errors during the process of diagnosis, then there are chances for false results.
Antibiotics are the best choice for venous ulcers. If the patient is experiencing pain, then the doctor will prescribe a few painkiller medicines. The patient will be asked to keep the leg in an elevated position. Most of the patients will require a surgical method for the treatment.
Angioplasty: Angioplasty is one of the useful procedures in which a balloon is used to open the artery that has been affected. This will help in enhancing the blood flow that was blocked earlier.
Amputation: If the angioplasty procedure cannot treat the blocked blood vessel, the doctor will recommend an amputation procedure. It is suitable for patients who have diabetic ulcers also.
It is necessary to follow all the instructions given by the doctor after the completion of the surgery.
To avoid vascular ulcers, first, the patient must prevent vein problems. This can be prevented by following healthy lifestyle habits. These changes will enhance the blood flow circulation in the legs, thus reducing the risk of vascular ulcers. The recommended lifestyle change to prevent vascular ulcers are:
Avoid being overweight or obese.
Stay at your ideal weight.
Raise or lift your legs for a shorter time, especially when standing all day.
Move around often.
Wearing compression stockings is also a beneficial method that provides advantages like:
Help to avoid significant swelling.
Prevent blood from pooling in the legs.
Reduce the risk of vascular ulcers.
Vascular ulcers can have a negative impact on an individual’s health. They have uneven borders, and they are shallow sores with a red base. The surrounding skin may appear discolored, shiny, hot, or warm.
Vascular ulcers manifest as venous ulcers and arterial ulcers. They are often found in the lower extremities. They can be chronic or recurrent. Vascular ulcers are mainly found on the outer side of the ankle, feet, heels, or toes. In severe cases, it may require amputation of the lower extremities.
The main symptoms of a leg ulcer include pain, swelling, and itching of the affected leg. In some cases, the discoloration can occur in the affected leg.
The treatment for venous stasis ulcers includes;
- Compression therapy.
- Leg elevation while resting.
If the patient has pain, painkillers can be given. Long-term treatments may require the use of double bandages, especially in elderly people.
Foot ulcers mainly occur in diabetic patients. If proper care is taken, foot ulcers are not very dangerous. However, if left untreated, it may cause gangrene. Then amputation may be required to treat such conditions.
Arterial ulcers are mainly caused due to blocked arteries. So the mainstay of treatment is restoring blood flow to the affected area. The underlying cause is treated. It may require medications, and in some cases, angioplasty has to be performed.
Vascular wounds mainly occur due to decreased blood supply mainly in the lower extremities. As there is decreased blood supply, these areas are deprived of oxygen resulting in the skin and tissues in that area. They are prone to infection if not taken care of in the initial stages.
Vascular ulcers may take more than three to four months to heal. In some cases, it may take even longer. If proper treatment and care are given, the healing can be quicker.
Vascular ulcers are often painful. The pain can get worse at night. The patient may experience pain in the lower ankle, foot, or lower leg. Patients may require painkillers in some cases.
Last reviewed at:
05 Mar 2022 - 5 min read
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