Venous leg ulcers

Key points about venous leg ulcers

  • A venous leg ulcer is a wound on your leg that takes a long time to heal due to poor blood circulation. It usually develops on the inside of your lower leg, above your ankle.
  • Often an ulcer will develop after a minor injury to your leg, and because of blood circulation problems, the wound fails to heal.
  • It can be be painful and itchy and cause swelling on your affected leg.
  • A venous leg ulcer usually won’t get better without treatment, which commonly involves specialist wound care and compression therapy.
  • Risk factors include being older, overweight, having a history of varicose veins or deep vein thrombosis (DVT), and having trouble moving around. 
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The most common symptom of a venous leg ulcer is a wound that doesn’t heal and is irregularly shaped with dry, hard skin around the outside. Other symptoms include:

  • swelling, especially around the ankle of your affected leg
  • aching legs
  • pain
  • clear discharge.

Venous leg ulcers are at risk of becoming infected because they’re slow to heal. Signs of an infected leg ulcer include:

  • increased pain
  • green, smelly discharge
  • developing a temperature
  • an increase in swelling and redness around the wound.

Image credit: 123RF

Venous leg ulcers develop because of problems with the blood circulation in your leg veins. Valves in your legs help to push blood from your legs and feet back up towards your heart. If these valves become damaged, the blood pools in the leg veins, causing pressure symptoms and skin changes.

Often an ulcer will develop after a minor injury to your leg, and because of blood circulation problems, the wound fails to heal.

You’re more at risk of developing a venous leg ulcer if you:

A venous leg ulcer is usually diagnosed based on what it looks like, how long it has been there, your history and other risk factors. Your GP may organise other tests to see if you also have peripheral vascular disease or check your circulation before starting treatment.

A venous leg ulcer usually won’t get better without treatment from a healthcare professional. The aim of treatment is to make sure the wound heals while providing relief from symptoms such as pain in and swelling of your affected leg.

Your GP may recommend specialist wound care and compression therapy to help with healing. Treatment will usually be done by a district nurse who is specifically trained to manage leg ulcers.

Compression therapy applies pressure to your affected leg, which reduces the amount of blood pooling in the veins and helps to redirect the blood flow to your heart. It can help to reduce swelling and encourages delivery of oxygen and nutrients, critical for healing, to the wound. 

Your GP may consider referral to a vascular surgeon to discuss a minimally invasive procedure for varicose veins. This will reduce the risk of recurrent ulcers.

Once treatment has started, venous leg ulcers can still take a few months to heal. You’re more at risk of developing another one if you don’t treat the underlying cause of the ulcer. Although some venous ulcers are unavoidable, there are a few things you can do to minimise your chance of developing one:

  • maintain a healthy weight
  • exercise regularly
  • eat a healthy diet
  • avoid sitting or standing for long periods
  • raise your feet as close to hip height as you can during the day to help with the return of blood flow to your heart.

Sometimes having varicose veins surgically treated can also help.

Venous ulcer(external link) DermNet NZ, 2016
Chronic venous insufficiency and leg ulcers(external link) Australian and New Zealand Society for Vascular Surgery, 2018
Venous leg ulcers(external link) Institute of Health and Biomedical Innovation, Australia
Care of venous leg ulcers(external link) Wounds Australia, 2012

References

  1. Australia and NZ Clinical Practice Guideline for Prevention and Management of Venous Leg Ulcers(external link) NZ Wound Care Society, 2011
  2. Treating venous leg ulcers(external link) NZ Wound Care Society, 2013

Brochures

venous leg ulcers institute of health and biomedical innovation australia

Venous leg ulcers

Institute of Health and Biomedical Innovation, Australia

care of venous leg ulcers wounds australia 2012

Care of venous leg ulcers

Wounds Australia, 2012

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Lupe Taumoepeau, vascular surgeon, Wellington

Last reviewed:

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