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A guide for people who have a slow to heal wound on their lower leg.

What is a leg ulcer?

A leg ulcer is a wound between the knee and ankle joint that is slow to heal.

Venous Leg Ulcers:

The most common reason that a wound on the leg does not heal (an ulcer) is because of problems with the veins in the leg.

The veins are the blood vessels in the legs that transport blood back to the heart. Sometimes, if the veins are damaged or not working properly, the blood pools in the legs and causes swelling and other problems.

In some people, a small injury does not heal because of the underlying vein problems. This is called a venous leg ulcer.

You might have a venous leg ulcer if:

  • You get swelling of your leg that is usually worse in the evening or after standing or sitting for a while
  • You have brownish discolouration of your skin (particularly near the ankle)
  • You have dry, itchy, scaly skin

A venous leg ulcer might:

  • Ooze a lot
  • Be shallow (not deep)
  • Look red and/or yellow (not black)
  • Be irregularly shaped
  • Seem to not get better or worse
  • Be painful

People with venous leg ulcers might have a history of:

  • Deep vein thrombosis (DVT / blood clot) in the leg
  • Pulmonary embolus (blood clot in the lung)
  • Being overweight
  • Multiple pregnancies
  • Varicose veins
  • Standing for long periods
  • Lack of ankle movement
  • Previous slow to heal leg wounds
  • Slow to heal leg wounds in other members of your family

Treating a venous leg ulcer

The best way to heal venous leg ulcers is with special bandages or stockings called compression therapy.

Compression therapy helps to squeeze the extra fluid (swelling) out of the leg and back into the circulation.

Compression therapy is a specialized treatment that should only be applied and used under the supervision of a qualified health professional.

Without compression therapy, your venous leg ulcer is much less likely to heal.

Help, information & treatment

Talk to your doctor or nurse about the best treatment for you.

Some areas have specialised leg ulcer clinics or services that can assist with treatment.

CARE OF VENOUS LEG ULCERS

Caring for your legs

In addition to wearing compression therapy, the following actions will assist healing of your venous leg ulcer.

  • When sitting, keep your leg elevated on a footstool – lie on a couch with your foot above heart level if possible
  • Walk as much as you are able to. When walking use a heel-toe action (don’t shuffle)
  • Avoid standing in one place
  • Regularly moisturise the skin on your legs and feet (but avoid applying moisturiser to open wounds or between your toes)

Once your venous leg ulcer has healed

It is recommended that compression stockings are worn daily to help prevent further venous leg ulcers.

Talk to your health professional about the best stockings for you.

Any wound below the knee that is not improving – or has not healed in 3 months – should be discussed with your health professional.

Venous leg ulcers can be treated.

This information is from the Australia and New Zealand Clinical Practice Guideline for Prevention and Management of Venous Leg Ulcers (approved by the Chief Executive Officer of the National Health and Medical Research Council [NHMRC] and published in October 2011.

More information is available online at

www.awma.com.au/publications

www.nzwcs.org.nz/publications