Arterial & Venous Ulcers

Skin ulcers are wounds (sores) that develop on your skin due to poor circulation of blood. When blood flow is blocked, the overlying skin and tissues don’t receive oxygen. This damages the tissue and causes the area to form an open wound.

There are different types of ulcers:

• Arterial ulcers. These occur when you have artery disease, such as peripheral artery disease (PAD), and are usually on your feet and toes. These are less common than venous ulcers.
• Diabetic foot ulcers. Diabetes can cause nerve damage, which can lead to a loss of feeling in your feet. This can result in unnoticed sores that can become serious foot ulcers.
• Venous ulcers. These are caused by damaged valves in your lower-leg veins, which disrupt normal blood flow and allow blood to flow backward. The abnormal blood flow causes the veins to get overfilled, and fluid seeps out into the surrounding tissues.

Prevention

One of the best ways to prevent ulcers from developing is to make sure you manage any underlying conditions that can affect blood flow, such as PAD, diabetes, high blood pressure or varicose veins. In addition, you can lower your risk by making lifestyle changes, such as:

• Get active. Exercise daily to improve your circulation. Try to avoid standing for long periods of time, and elevate your legs when you’re sitting.
• Maintain a healthy weight. Excess weight increases the pressure in your legs, which can damage your skin. If you’re overweight, lose weight to lower your risk.
• Quit smoking. Smoking reduces blood flow and slows wound healing.
• Wear compression stockings. When you wear these during the daytime, it can improve circulation in your legs.

Symptoms

Signs that you may be getting an ulcer are:

• Aching pain in your legs after standing for a long period of time.
• Brown discoloration or staining on your skin.
• Heaviness in your legs.
• Irritated, red or flaky skin, or scabbing or hardened skin around a sore.

Diagnosis

Your doctor will examine the wound and do tests to evaluate blood flow. Tests may include one or more noninvasive diagnostic exams, such as:

• Ankle-brachial index – Measures your blood pressure at your ankle and your wrist.
• Vascular ultrasound – Examines the inside of your blood vessels to look for narrowing or blockages.
• CT angiography – Identifies blocked or narrowed blood vessels.

Treatment

Your treatment may include one or more wound care therapies — such as removing dead skin (debridement) and specialized dressings — depending on your health and the severity of your ulcer. Other treatments may include:

• Medicines to treat infection.
• Compression bandages or stockings to improve circulation.
• Elevation of your legs when you’re sitting to relieve pressure.
• Minimally invasive procedures to restore blood flow in blocked blood vessels.