Is it a Wound or an Ulcer?

There appears to be confusion of when a wound becomes an ulcer.  The answer is simple. Any wound that does not heal within a 'normal; time expectancy will be known as an ulcer.  However, the wound and ulcer are the same thing and it is just a matter of how successful the healing of the wound.

Wounds are nearly always the result of poor blood supply.  With a pressure ulcer, the blood is not reaching tissues over a bony prominence and the tissue dies.  In arterial leg ulcers, the blood is not successfully reaching the feet.  In venous leg ulcers the blood is not successfully returning to the heart.  Therefore, the answer is simple - correct the blood supply.

In venous leg ulcers, returning blood to the heart is fairly simplistic.  The veins have small valves in them that assists the blood upward to the heart.  At the same time, breathing creates a suction effect on the blood vessels and will pull the blood back to the heart.

Unfortunately, the valves sometimes fail and that means that the blood does not successfully return to the heart but drops back down toward the feet, causing a 'back log' of blood which, in turn, causes a swelling in the feet and the legs.

At the same time, the engorged veins open a little and let red blood cells and fat to enter the tissues.  The red blood cells contain iron and this stains the skin, causing a brown staining that is like a tattoo and will never disappear.  this has a name of haemosiderin staining and is a sign that a venous leg ulcer will occur if the leg receives a knock.

It is common for people to say: "My leg ulcer was caused by a supermarket trolley".  However, a leg ulcer will be just waiting for the knock so that it can  make its presence known.  Anyone with this brown staining, or varicose veins or little red/blue blood vessels of the ankle, should consider having their legs assessed by a local Leg Club where they will receive advice on how to avoid the leg ulcers.

• Taking Care of Your Legs - PDF