Tailored Treatment for Venous Leg Ulcers in Melbourne
Venous leg ulcers are visible sores that can take weeks or, on occasion, months to heal. Often caused by vein and blood flow issues, they occur most commonly near the ankle. Sometimes referred to as venous ulcer disease, they may be related to other conditions such as varicose veins, blood clots or a disease of the veins. As fluid leaks from an abnormal vein, the skin starts breaking down leading to the creation of deep sores in the skin.
Vein Care specialises in venous ulcer treatment in Melbourne. Early intervention is crucial as the condition can quickly worsen. This puts you at risk for complications such as infections and even loss of affected limbs.
Understanding Leg Ulcers
Venous or varicose ulcers occur when oxygen-depleted blood can’t flow from extremities like your leg back to your heart. This causes it to pool in veins where it creates pressure and can eventually damage skin tissue, leading to an ulcer.
The main symptom is a visible deep sore on your leg. The sore itself can weep while the surrounding skin might be dry or have a rash. When the leg ulcer gets infected, additional symptoms include:
- Swelling
- Pus
- Foul smelling fluid
- Pain that gets worse
- A fever
Unlike cuts or grazes which can only affect a few layers of skin, venous ulcers affect the whole thickness of skin. This means they can take a long time to heal and often leave a scar. Venous ulcers are common, especially in older people, affecting around one percent of the Australian population.
Causes of a Varicose Ulcer and Risk Factors
Veins in our body contain a one-way valve that prevents blood running backwards. These veins rely on the contraction of muscles to move blood along the veins back up towards the heart. This process can be disrupted due to poor blood flow, caused by high blood pressure, blood clots, vein diseases, blocked arteries, skin conditions, injuries and infections. Risk factors that increase the likelihood of developing venous ulcers include:
- Varicose Veins: The one-way valves in your veins usually prevent blood from travelling backwards. When they stop working, pooling blood stretches and distorts the vein. These twisting, bulging veins add pressure to skin tissue.
- Older Age: Veins gradually weaken as we grow older, with circulation becoming less efficient. Our skin also loses elasticity due to collagen depletion, making it easier for the tissue to break as pressure builds from blood pooling in the vein.
- Cigarette Smoking: Tobacco consumption constricts the vessels of the circulatory system, increasing the risk of poor blood flow.
- Arterial Disease: Vein problems are more likely if you have other diseases of the arteries.
- Certain Disorders: Medical conditions such as diabetes and arthritis can affect the efficiency of your circulatory system.
- Family History: You may be genetically predisposed to developing vein conditions like varicose veins, spider veins and venous ulcers.
- Sedentary Lifestyle: Long periods of sitting, for example at work, coupled with minimal physical activity, can increase your risk.
- Higher Body Weight: Excess weight creates additional pressure on the circulatory system, especially in the lower body.
- Pressure Sores: People who are bed-bound can develop pressure sores, which occurs when the skin is damaged from constant pressure or friction.
- Medication: Certain cardiovascular medications can also contribute to swelling in the legs due to a build-up of fluid (leg oedema) and altered circulation.
Other risk factors include having had certain surgeries such as a knee replacement, or a previous injury that has caused paralysis or impacted circulatory health in the area.
Diagnosing Venous Ulcer Disease
To diagnose the causes of a varicose ulcer, a specialist will conduct a physical examination of the wound as well as a review of your surgical and medical history, ultrasound imaging tests and laboratory tests. One of these tests is the ankle-brachial index, which compares blood pressure at your ankle and arm using a Doppler machine. This detects discrepancies in blood flow around different parts of your body, helping to pinpoint the cause of the ulcer.
Distinguishing your leg ulcer as a venous ulcer, as opposed to an arterial ulcer or some other health condition, is important for effective treatment. In some cases, a doctor may recommend an angiogram, which is a special x-ray examination to look for an arterial ulcer and determine whether surgery is necessary to clear a blockage.
Venous Ulcer Treatment and Management
Your tailored treatment plan will depend on what type of leg ulcer you have, what caused it and the severity of the condition. It may include:
- Wound Cleaning: Replacing wet and dry dressings at recommended intervals as well as using ointments to eliminate bacteria and remove dead tissue.
- Specialised Dressings: Several products are available to help the stages of wound healing, including occlusive (air- and water-tight) dressings that help ulcers heal by keeping them covered.
- Compression Treatment: This boosts internal pressure and reduces blood pooling in the area, using either elasticised bandages or specialised compression stockings.
- Medication: Depending on the case, treatment may include pain-relieving medication as well as oral antibiotics to address any infection.
- Elevation: You may be advised to keep your leg elevated above heart level whenever possible, to reduce pressure in the veins and help the ulcer heal.
- Treating Vein Conditions: Your doctor will address underlying vein conditions that may have caused the ulcer, such as treating varicose veins with ultrasound guided sclerotherapy or endovenous laser treatment.
- Supplements: Certain mineral and vitamin supplements may encourage faster healing on a leg ulcer, including iron, zinc and vitamin C, but only if a deficiency is detected.
- Skin Graft: A surgical procedure that involves grafting healthy skin onto the wound site, only necessary if there has been significant tissue lost due to the ulcer.
Other specialised treatments that may be used in rarer cases include hyperbaric oxygen therapy, lymphedema therapy and growth factor therapy.
Types of Ulcers
During the diagnostic process, it’s important to differentiate between venous ulcers and arterial ulcers. These share similarities but are quite different in terms of their causes, characteristics and treatment methods. Arterial and venous ulcers are both open sore wounds found on the body, commonly on lower extremities like your legs and feet.
While venous ulcers develop from damaged veins, arterial ulcers develop due to damaged arteries from a lack of blood flow to tissue. Arterial ulcers most often develop on ankles, feet, toes and heels on the smaller side of arterioles and capillaries. Compared to venous ulcers, they tend to be more painful and exhibit differences in appearance, including:
- A small, deep, round wound that looks like a hole punch
- Well defined borders
- Various colouring from pale to red, brown, yellow, grey and black
- No bleeding
- The surrounding skin is often hairless, cool to the touch and can feel itchy or tight
Venous ulcers, by comparison, tend to be larger, shallower wounds with an inflamed base. With irregular and uneven borders, they are more likely to appear moist and weepy. Skin surrounding the area can be hot to the touch. Proper diagnosis of a leg ulcer is essential to address the underlying cause of the circulatory issue and encourage effective wound healing.
Choose Vein Care for Expert Vein Therapy
Vein Care specialises in diagnosing and treating vein conditions, including venous ulcer, varicose veins and more. Our experience, state-of-the-art technology and patient-centred approach ensures the best possible results that address the underlying cause of the condition. This includes utilising vascular ultrasounds, which offers detailed, real-time information about blood flow using a safe, non-invasive method of high frequency sound waves.
Through extensive vein mapping, we can provide an accurate diagnosis to create the best treatment plan for your venous ulcer while minimising the risk of recurrence. Whether that ends up being a laser procedure or one of our minimally invasive, non-surgical injection treatments, we focus on finding the best outcome for long term health and relief.
Make an Appointment with Vein Care in Melbourne
For quality treatments for a venous ulcer, varicose veins, spider veins and deep vein thrombosis, book an appointment with Vein Care today. Our dedicated experts provide specialist care that prioritises your health, welfare and comfort. Our minimally invasive procedures reduce pain and maximise long-term results.
To find out more or to make an appointment, call us today on 1300 730 100 or contact us online.