Venous and Arterial Leg Ulcers​

What Are Venous and Arterial Leg Ulcers?

Venous and arterial leg ulcers are wounds or open sores on the legs or feet that won’t heal. They develop due to poor blood circulation caused by damage to the veins or arteries in your legs and feet.

What are the types of venous and arterial leg ulcers?

There are two types of leg ulcers, including:

• Arterial leg ulcers — Caused by damage to your leg arteries that prevents blood flow to your lower legs and feet.
• Venous leg ulcers — Caused by damage to your leg veins that prevents blood flow back to your heart.

What is the difference between arterial and venous ulcers in the leg?

Arterial leg ulcers are caused by damage to your arteries, which carry blood from your heart to your lower legs and feet. Venous leg ulcers are caused by damage to your veins, which return blood from your feet and legs to your heart.

How common are venous and arterial leg ulcers?

Research shows chronic leg ulcers affect about 1 million people in the U.S. Venous ulcers are the most common type of leg ulcer, making up about 70% of leg ulcer diagnoses.

What causes venous and arterial leg ulcers?

Poor circulation is the main cause of venous and arterial leg ulcers. Venous leg ulcers are caused by damage to the veins, and arterial leg ulcers are caused by blocked arteries.

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What Are the Signs and Symptoms of Venous and Arterial Leg Ulcers?

Symptoms of venous and arterial leg ulcers may include:

• Discharge from the wound.
• Enlarged veins.
• Hairless skin surrounding the wound.
• Inflammation and swelling around the wound.
• Itchy skin.
• Little or no bleeding.
• Pain or heaviness in the legs.
• Red, yellow, or black open sores.
• Scabbing or pus.
• The area around the wound feeling cool to the touch.

What does a leg ulcer look like when it starts?

You may notice a shallow, open sore on the skin of your foot, ankle, or lower leg. It may be painful, but sometimes ulcers do not cause pain due to nerve damage from conditions such as diabetes.

The sore may also have a yellow or white coating, and the surrounding skin may look reddish and swollen. Although ulcers don’t typically bleed, you may notice pus around the wound.

When should I see a doctor about my venous and arterial leg ulcer symptoms?

If you have symptoms of venous or arterial leg ulcers, you should schedule an appointment with your doctor as soon as possible. Getting early treatment may reduce your risk of developing serious complications.

What are the red flags for venous leg ulcers?

“Red flag” or serious symptoms that require immediate treatment by your doctor include:

• A wound that is getting bigger.
• Enlarged veins.
• Leg swelling.
• Open sores on your lower legs or feet.
• Pus around the wound.
• Pain or heaviness in your legs.

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How Do You Diagnose Venous and Arterial Leg Ulcers?

To diagnose a venous or arterial leg ulcer and develop a customized treatment plan, a wound healing expert will examine the affected area. They may also order tests to determine the cause of your ulcer.

What to expect during your visit

If your doctor suspects a venous or arterial leg ulcer, they will:

• Perform a physical exam.
• Ask you about your symptoms.
• Order tests.

Tests to diagnose a venous or arterial leg ulcer

Tests to help your doctor diagnose a venous or arterial leg ulcer may include:

• Biopsy — A procedure to take a small sample of abnormal tissue for analysis in a lab.
• CT scan — A test that creates images of your body's organs, bones, and tissues.
• MRI — A procedure that uses large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within your body.
• PET/CT — A combined imaging test that can identify dying (necrotic) tissue.
• Ultrasound — Uses sound waves to create images of the inside of your body to check for problems with blood flow.
• X-ray — Creates images of the bones and tissues inside your body.

Venous and arterial leg ulcer prognosis

With treatment, it is possible to reduce leg ulcer symptoms, heal your wound, and improve your quality of life. If left untreated, leg ulcers can cause serious complications, including infections that spread to the bone and other areas of the body.

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How Do You Treat Venous and Arterial Leg Ulcers?

Treatment for venous and arterial leg ulcers can help to reduce symptoms, heal the wound, and improve your quality of life. Treatment options may include:

Nonsurgical treatments for venous and arterial leg ulcers

Nonsurgical treatment options may include:

• Advanced wound dressing — Uses specialized bandages and medications to promote wound healing.
• Bioengineered skin substitutes — Grafts that are applied to wounds to promote healing of damaged skin.
• Compression — Specialized bandages help to reduce swelling, improve circulation, close the wound, and reduce the risk of infection.
• Lifestyle changes — Managing chronic conditions, eating a healthy diet, getting regular exercise, quitting smoking, and maintaining a healthy body weight to promote healing.
• Orthotics or braces — Improve mobility while preventing future ulcers.
• Systemic hyperbaric oxygen therapy — A treatment where you breathe 100 percent oxygen in a pressurized chamber to increase oxygen levels in your blood and promote healing.

Surgical treatments for venous and arterial leg ulcers

Our wound care team has experienced orthopaedic, vascular, podiatric, and plastic surgeons who can assess and treat an array of nonhealing wounds. We offer procedures to improve circulation and treat nonhealing wounds. Surgical treatment options for venous and arterial leg ulcers may include:

• Vacuum-assisted wound closure — In advanced wound healing, vacuum-assisted closure is used to help drain blood or fluid from a nonhealing wound.
• Wound debridement — Involves removing infected or nonviable tissue from the site of a wound to speed healing.

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