Leg Ulceration

Symptoms &  effective treatment

By Mr Michael Gaunt MA MD, FRCS MB ChB BSc

“I perform a thorough vascular assessment utilising Duplex ultrasound scan and other specialised tests to diagnose the condition and apply the correct treatment”

Varicose veins are a common cause of leg swelling and leg ulcers even if the varicose veins do not appear that visible. In some patients the venous circulation of the leg is so abnormal – due to the leaky vein valves – that swelling, pigmentation of the leg and ulceration around the ankle occurs. This is a serious condition which can result in loss of the limb and requires careful assessment.

“Varicose veins are a common cause of leg swelling and leg ulcers a serious condition which can result in a loss of the limb”

Swelling and ulceration can be caused by abnormalities in the superficial veins, the deep veins or both. If the superficial veins are the cause this can usually be treated by usual varicose vein treatments. If the deep veins are the cause, conservative therapy with compression bandages and stockings can usually reduce the swelling and heal the ulcers.

For ulcers resistant to standard compression treatment, more specialised therapy with Manual Lymphatic Drainage (MLD) and the use of specialised medications can be successful. Occasionally surgery on the deep veins is indicated.

A thorough assessment utilising Duplex ultrasound scan and other specialised tests such as venous plethysmography are essential to diagnose the condition and apply the correct treatment. Venous plethysmography can also be used to measure whether the compression bandaging is actually correcting the venous abnormality.

Although, venous eczema and ulceration can respond to local treatments alone, all the scientific evidence suggests that the condition will recur unless the underlying venous problem is corrected.