Leg Ulcer – Potentially Life Threatening if Untreated

What is Leg Ulcer?

An ulcer is a break in the upper layer of the skin called the epidermis. This provides an entry way for bacteria and other infectious agents into the other layers of tissues below. Ulcers can form in any part of your body where the blood supply is poor and for most people, leg ulcers occur mainly in the lower limb or calf. In most people minor breaks in the skin will heal up without difficulty within a week or two.  However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size.  This is a chronic leg ulcer.


What causes Leg Ulcers?

Leg Ulcers are found mainly in people with illnesses and diseases which cause decreased blood supply to the body and lower extremities, most commonly venous insufficiency. If you are a diabetic patient, or suffering from hypertension, renal disease, drug addiction, alcoholism, congestive heart failure or rheumatoid arthritis you are at a higher risk to have leg ulcers. People in sedentary jobs where they spend long hours in a sitting position are prone to leg ulcers, due to disruption of blood supply.

The elderly and obese individuals are the main targets due to their inclination to less activity. Some leg ulcers that do not heal may require amputation, hence it is necessary to take prevention precautions, especially for diabetic patients. It is a debilitating illness and greatly affects involvement in social activities, therefore their quality of life is often impaired.

There are two major types of Leg UlcersLeg Ulcer2

A: Venous Diseases: Decreased ability of the veins to shunt blood back to the heart

B. Ischemic Ulcers/Arterial Diseases : A narrowing of arteries or damage to small blood vessels leading to decreased circulation in the leg.

Venous diseases such as venous insufficiency is the main reason for over two thirds of all leg ulcers. In some severe cases, both conditions may be affecting the ulcer at the same time.


Symptoms of Leg Ulcers

One of the first signs you will see is dry itching skin and tenderness at the site. Should your condition worsen other symptoms will develop such as;

• A stinging pain and tenderness at the site

• Increased pigmentation around the area. Skin becomes red then gets darker than the rest of the leg

• Pitting edema: the site around the ulcer pits or sinks into a depression when pressed

• Atropine Blanche: Areas of skin around ulcer bleached pinkish white in appearance with red spots

• Decreased blood supply to the area.

• A feeling of heaviness in the leg and difficulty walking

Spider veins and varicose veins may also be the symptoms of venous insufficiency that leads to leg ulcers.

Diagnosis of Leg Ulcers

To treat your leg ulcers it is best to see a vascular specialist where a complete diagnosis can be made. This is usually determined by your symptoms and medical history. If you have signs of a deep vein problem, the doctor may do a vascular ultrasound test to examine if there are any evidence of a blood clot. Our Vascular Surgeon is one of the few  in Singapore trained to do this non-invasive test. With his ability to do a vascular ultrasound test in the same consultation, our doctor can quickly diagnose and recommend customised procedures to prevent the worsening of the diseases.


Leg Ulcers Treatment Options

The goal of treatment is to provide oxygen to the area, reduce the inflammatory and infectious process and remove dead tissue so healing can take place. Local application of ointments mostly of sulfur variety is usually recommended, with large doses of antibiotics for bacterial infection. Should gangrene occur, a stage in which there is greater tissue damage, surgical intervention may be necessary to remove old dead tissues to encourage healing. If your ulcer is due to varicose veins then these may be treated, usually once the ulcer has healed.


Find out more about Leg Ulcers and Treatment options

Our doctor regularly conducts free public educational forums at his clinic. Contact us  now if you will like to be informed about the next forum or make an appointment with our doctor for a consultation.

Why choose treatments by our doctor?

Being among the few vascular and endovascular trained surgeons in Singapore, our doctor can provide comprehensive services from diagnosis to treatment. Our clinic always adopts the latest minimally invasive technology to reduce the recovery of our patients. During the assessment of your deep vein thrombosis, our clinic will conduct a sonography (vascular ultrasound) examination to diagnose for issues in the veins hidden deeper in your legs. This can be done onsite during the same consultation as he is able to do the ultrasound personally instead of making another appointment with a technician. This allows our doctor to explain the results to you immediately and prescribe a customised treatment for you that is best suited for your body and preferences.

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