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Ulceration

Information for Medical Conditions

What is an ulcer?

Doctor treating Ulceration with medical cream
An ulcer is simply a break in the skin, which allows air and bacteria to get into the underlying tissue. The problem starts from an injury, often a very minor one that breaks the skin. Leg ulceration is one of the most common cases of ulcers. A leg ulcer is a sore, which should heal without the difficulties within a week or two. However when there is underlying problem, such as poor blood circulation, long-lasting (chronic) sore might develop and take more than a month to heal. They usually develop on the inside of the leg, just above the ankle.

The most common cause of chronic leg ulcers is poor blood circulation in the legs, and they might form due to problems with the arteries or, more commonly with the veins, or to a mixture of both.

The veins in the carry the blood back from the foot towards your heart, against the forces of the gravity. The veins have one-way valves that make sure the blood flows only in one direction –  up the legs. In some people, these valves are not very efficient or they can be weakened or damaged by the formation of clots in the veins. 

If the valves don’t work properly, blood can flow the wrong way down the veins, resulting in a very high pressure in the veins when standing up. This abnormally high pressure in the veins damages the skin and leads to the ulcers.

Most chronic leg ulcers heal within three to four months if they’re treated by a healthcare professional. However, some ulcers may take longer to heal, and a very small number never heal.

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What are the symptoms?

The symptoms of a venous leg ulcer include pain, swelling and itching of the affected leg. There may also be discoloured or hardened skin around the ulcer, and the sore may produce a smelly discharge. People at the highest risk of developing ulcers are those who suffer from osteoarthritis, have a history of a leg injury, are obese or paralysed. The risk is also higher in people who recently had an operation on leg, such as a hip replacement or knee replacement and suffer from varicose veins.

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