Innovative Leg Ulcer Care and Treatment in the Knoxville, TN Area
What is a Leg Ulcer?
Leg ulcers are open wounds on the skin of one or both legs.
Venous ulcers account for up to 90% of leg ulcers.
The most common site of venous ulcers is on the inner part of the leg just above the ankle. They may also occur on the shin and other areas surrounding the ankle. They are typically not seen on the foot or toes, which are common sites for arterial insufficiency ulcers and diabetic ulcers.
Venous ulcers are highly variable: they can be small or large, shallow, or deep, dry and crusty or oozing with drainage, and painless or painful.
Venous ulcers are often seen in conjunction with chronic leg swelling and preceded by venous insufficiency skin changes, including:
Corona Phlebectatica Paraplantaris
This term means “a crown of dilated veins around or near the foot.” In the early stages, this may appear as a cluster of spider veins around the inner area of the ankle and foot. This is one of the earliest findings of venous insufficiency. In the later stages, Corona Phlebectatica can appear as severely dilated, dark purple spider veins (telangiectasias) surrounding the ankle or foot.
Deposits of iron in the form of hemosiderin can result in localized brown discoloration of the skin when there are long-standing varicose veins or signs of chronic venous insufficiency.
This term means “white areas that are wasting away.” This condition appears as areas of white scars or ivory-white plaques in the skin that may be slightly depressed and surrounded by redness or pigmentation.
This itchy dermatitis is red and scaly and can arise as discrete patches or affect the leg circumferentially. In more severe cases, it may ooze, crust, and crack.
There can be several skin changes associated with Lipodermatosclerosis. The changes in skin color can include pink, red, and purple discoloration, which eventually turns brown. In addition, the skin may become thickened, hardened, tight, and smooth. These areas often become painful.
Leg Ulcer Symptoms
For most leg ulcers, symptoms depend on the type of ulcer you are experiencing.
Common symptoms of leg ulcers universally include:
- the presence of an open wound in a crater-like shape
- changes in skin texture
- yellow or green pus discharge
Refer to each type of leg ulcer below for specific symptoms to note.
Types of Leg Ulcers
While venous leg ulcers are the most common type, there are two other types to be aware of.
1. Arterial Ulcers
Arterial ulcers are the second most common cause of leg ulcers, accounting for about 15% of cases.
Their cause is related to the arteries and is the opposite of the problem with venous ulcers. Arteries carry oxygen and nutrient-rich blood to the tissues. When you experience a blockage in the arteries, that blood can’t reach the tissues. This causes the tissues to die.
Smoking is one of the most significant risk factors for developing problems with your arteries. This is because smoking causes plaque to build up in your arteries and causes them to get smaller. Smaller arteries mean less blood flow. This is equivalent to suffocating your tissues.
Symptoms of arterial ulcers include:
- Pain at the site of the ulcer, which often worsens at night
- Pale skin
- A deep with a “punched out” look
- Difficulty and pain while walking
Treatment of arterial ulcers usually requires surgery with a vascular surgeon to help restore regular blood supply to the area.
2. Diabetic Ulcers
It is estimated that 5% of ulcers are related to diabetes.
Diabetic ulcers vary slightly in their cause, as it is related to high blood sugar levels instead of being caused by improper circulation.
Diabetes is characterized by abnormally high blood sugar levels in your bloodstream. This is caused by your body’s inability to make or use insulin properly. Insulin acts like a “key” that allows glucose (sugar) entry into the individual cells. Glucose is the fuel, or energy source, for your cells.
When insulin isn’t available, glucose wanders around banging on your cell’s locked doors. All this excess glucose starts damaging your fragile tissues (the micro-circulation), causing irreparable destruction.
Due to this repeated damage, you start to lose feeling, especially in your feet. In addition, repeated trauma puts you at risk of developing sores or ulcers on your feet. A known culprit is ill-fitting footwear.
Often painless unless an infection is present, symptoms include:
- Callused blisters that range from red to black in color
- A wound that may appear macerated
Regular foot exams by your provider can help detect early signs of damage.
Leg Ulcer Causes
Healthy blood flow is an essential component of wound healing. The risk of developing venous leg ulcers increases when people are diagnosed with poor circulation due to conditions such as venous insufficiency.
For those with blood circulation troubles or a venous insufficiency diagnosis, minor scrapes or small cuts can quickly lead to something more severe as they cannot heal as swiftly or adequately as they should.
Over time, if a wound is left untreated and doesn’t heal on its own, it can form one or more leg ulcers.
When venous hypertension is present, skin changes and skin breakdown resulting from venous ulcers are triggered by inflammatory mediators.
Venous hypertension is increased blood pressure in the lower leg's veins, typically caused by venous insufficiency. Venous insufficiency results when there is an inadequate return of blood from the legs back to the heart.
The most common cause of venous insufficiency is venous reflux from underlying or visible varicose veins that are not functioning normally. Venous insufficiency will result when functioning veins cannot compensate for the damaged and refluxing veins.
Another cause of venous insufficiency is obstruction from a previous or acute deep vein thrombosis (DVT). If swelling, symptoms, or skin changes develop acutely, it could indicate an acute DVT, a medical emergency that requires immediate evaluation.
Leg Ulcer Treatment
Our experienced team offers various treatment options to care for your leg ulcers effectively.
The most important step with venous ulcers is an accurate diagnosis, which is the first step for treating any vein disease condition.
Dr. Campbell has treated venous ulcers and other related venous issues since 2003. Medical consultation and duplex venous ultrasound are the first steps to diagnosing any venous problem to determine the cause of the ulcer and the best treatment option for you.
After a proper diagnosis, addressing the underlying cause of venous ulcers, treatment of the vein disease with sclerotherapy and Endovenous thermal ablation treatment should begin as soon as possible.
New England Journal of Medicine recently published a study recommending the immediate treatment of venous ulcers provided quicker healing time.
Treatments have been shown to reduce healing time by as much as 50% and to reduce the likelihood of recurrence. As with other vein diseases, venous health can be improved with exercise, leg elevation, wearing compression socks, and avoiding prolonged sitting or standing.
Effective Venous Leg Ulcer Treatment Options Near Me
If you or a loved one are living with leg ulcers or another type of condition such as spider veins or facial veins, we can help.
Intervening early can help prevent the escalation of pain and progression of symptoms while reducing your risk of developing more severe health complications.
Tennessee Vein Center provides effective treatment options throughout the Knoxville area to help you feel your best sooner. Schedule an appointment today to start your journey to healthier circulation and a leg ulcer-free future.