Leg ulcers (defects in the skin) can become chronic wounds which are at risk of infection and can cause pain. Chronic leg ulcers may require hospitalization to treat. If left untreated, severe ulcers can progress and threaten the leg.
Over 95% of leg ulcers are caused by disease in the veins, disease in the arteries, diabetes, infection, or a combination of these.
Less than 5% of ulcers are caused by rare conditions, such as vasculitis, scleroderma, pyoderma gangrenosum and skin cancer.
The key to healing a leg ulcer is identification of the underlying cause (or causes) and effective early treatment.
Assessment:
If you develop a leg ulcer, Mr Milne will thoroughly assess the ulcer and the leg to establish the underlying cause. A key part of this is looking for underlying disease in the arteries or veins. A duplex ultrasound of the leg arteries and veins may be performed, in addition to blood pressure measurement at the ankle and in the toes. Wound swabs may be taken, and occasionally a biopsy of the ulcer.
Management:
Treatment for leg ulcers is variable, and is tailored to address the underlying cause.
For example, an ulcer caused by superficial venous insufficiency and varicose veins is treated with compression stockings and eradication of any underlying infection. To prevent recurrence, the varicose veins can then be treated (see varicose veins).
On the other hand, an ulcer caused by disease in the arteries is treated by improving the blood supply to the leg (see aortoiliac & lower limb arterial disease) and eradication of any underlying infection.
For rare causes of ulcers, Mr Milne works closely with a team of specialists including dermatologists, rheumatologists, and infectious disease physicians to help diagnose and treat the underlying condition.
After treatment, Mr Milne will ensure regular review of the affected leg until the ulcer is entirely healed.
