What ​is​ an Ulcer?

An ulcer (non-healing sore) in the skin refers to a place where the normal skin covering has been wiped away and the subcutaneous tissue under the skin shows through. Most common cause of ulcers between the knee and the foot is leaking venous valves causing high pressure and abnormal circulation in the tiny vessels of the skin. Ulcers represent a late stage of lower extremity vein disease when the abnormal circulation from long standing reflux in the superficial or other veins causes the skin to become thickened and inflamed and it actually breaks down into an open sore.

Ulcers may affect anyone with abnormal venous mechanics but they are more common in older people, and are about equally frequent in men and women. Venous leg ulcers can be painful or painless. Without proper treatment, an ulcer may grow progressively larger until it encircles the leg and causes severe disability for the individual. What Are Some Causes of Leg Ulcers?

Identifying the Cause of Venous Ulcers

The root of the problem is increased pressure of blood in the veins of the lower leg. This causes fluid to ‘ooze out’ of the veins beneath the skin, followed by swelling, thickening, and damage to the skin. The damaged skin may eventually break down to form an ulcer.
The increased pressure of blood in the leg veins is due to blood pooling in the smaller veins next to the skin. This pooling occurs because the valves in the larger veins are damaged by a previous thrombosis (blood clot) causing blockage of the vein, or by weakening of the walls of the veins causing the valves to malfunction,
as in varicose veins. When the valves no longer function properly gravity causes blood to backflow down the leg in the erect individual and pool in the lower leg veins. This produces high pressure in the veins which results in damage to the surrounding tissue and ultimately to skin breakdown and ulceration.

What can be done if I do have Venous Leg Ulcers?

Accurate diagnosis in leg ulcers needs to identify the cause of the ulcer and show the specific veins that are malfunctioning. Treatment for all leg ulcers requires carefully prescribed elastic stockings or rigid leg coverings. In addition, many of the problems that cause the ulcers can be repaired by techniques such as injection treatment, minimally invasive elimination of certain veins using laser, or reconstructive surgery in the deep veins. Some of this can be done in our office, and other parts of the treatment may require in-patient hospital procedures. With specific diagnosis and aggressive correction more than half of leg ulcers can be healed well enough to prevent their recurrence.