Q. It has been months, and still, my mother's leg wound has not gotten better. Why?

Answered by
Dr. Lalit Kumar Bansal
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jun 10, 2020 and last reviewed on: Apr 17, 2021

Hi doctor,

I need an opinion from a general surgeon regarding my mother's wound. My mother is 81 years and she has wound for a year. She has consulted three doctors and done some laboratory tests. Based on her reports, the first doctor suggested her to use Mupirocin ointment and Mefenamic acid. It has not helped her. She usually have wound in the same area during her young age.



Welcome to

I have gone through the image and laboratory reports of your mother (attachment removed to protect patient identity). She has an ulcer in her leg on the medial aspect. It seems to be a chronic non-healing ulcer as the margins are sharp and the base is filled with yellow debris. In healing ulcers, the margins are sloppy and the base is filled by healthy red granulation tissue. But in your mother, it is of non-healing type. There are many reasons to have a non-healing ulcer at this age. The reasons are diabetes, hypertension, and immunodeficiency. As your mother is 81 years, then it may be a probable cause and her blood investigations appear normal.

The other reason can be varicose veins. It can present along with this type of ulcer in the medial side of the leg where the ulcer is located. To confirm the diagnosis, you need to send an image of the whole leg to see for dilated veins. It is good to do a venous doppler exam on both legs to rule out varicose veins. There is no need to take antibiotics as there is no active pus discharge. Now, it can be treated by scraping the dead floor and margins of the ulcer to have faster healing. It is done by a local surgeon. You can apply Mupirocin ointment. She can start taking vitamin C 1 gm daily for enhancing immunity and it helps for healing the ulcer.

Thank you doctor,

I am attaching the image. It is hard to schedule a doppler now. What to do?



Welcome back to

I have gone through the reports. Her venous system is normal. There is atherosclerosis in the lower limb vessels and stenosis on the right proximal tibial artery. It does not have any direct impact on the healing of the ulcer. But it indirectly delays healing due to improper blood supply. She may have pain during or after walking in her calf muscle due to it. To fasten her healing, debridement is needed. It is nothing but it involves freshening of margins by cutting the small part until they bleed. It includes scraping of the floor to remove yellow debris until it looks red with fresh blood. It can be done by a general surgeon. Healing takes place only when the margins are fresh with fresh bleeding. Good nutrition is the key factor to promote healing.

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