Heal Venous Leg Ulcers

You have probably heard of venous ulcers if you have diabetes or problems with your circulation. Venous leg ulcers are common, and are caused by minor injuries to your skin when you have poor blood flow and circulation in the veins of your leg. They can heal with proper care, but without it they can cause serious complications. It's very important to see a doctor or wound care nurse when you have an ulcer, then to keep them dressed and bandaged, take the right medications, and alter some of your habits at home.

Steps

Getting Medical Care

1. Visit your doctor or a wound clinic. Cleaning and dressing the wound is an important first step, but this should be done by a trained healthcare professional. They will clean any debris or dead tissue from your wound and apply a clean non-stick bandage. It’s very important to visit your healthcare provider right away for treatment if you notice you have an ulcer on your leg.
2. Learn how to change your dressing. Leg ulcers should heal in about 3-4 months with proper care. In the mean time, your dressing should be cleaned once a week. Often, this requires professional care. Some people can learn to do this at home with proper training, so ask your healthcare provider to show you exactly how to change and reapply your dressing, and whether that's something you can attempt on your own.
   • If you do not feel comfortable changing your own dressing, that’s okay! Ask your doctor if you qualify for a home-care nurse to come by and help you once a week. You can also visit a wound care clinic weekly.
3. Wear a compression bandage. Your doctor or nurse will give you a compression device to wear over your dressing. This improves circulation to your leg, and is probably the most important step in healing your ulcer. Wear this exactly as your healthcare provider directs you to, and do not remove it without permission – it should only be applied and removed by a healthcare provider. Usually, you will wear your bandage continually until your wound heals, and your nurse will help you change it once a week when you change your dressing.
   • The compression bandage may feel painful at first. This will improve in about 10-12 days. Ask your doctor for a pain medicine like paracetamol, or ask how best to manage the discomfort.
   • Call your nurse if you have any problems with your compression bandage. Don’t try to take it off yourself.
   • There are several different kinds of compression bandages, and none are proven to be better than the others.
4. Call for help with your compression bandage if you experience severe pain or swelling. It’s normal for your bandage to feel tight at night – getting up and taking a short walk may help. However, contact your nurse or doctor right away if you experience any of the following problems:
   • Severe pain in the front of your ankle
   • Severe pain on the bottom of your foot
   • Swelling in your toes that turns your toes blue
5. Ask your doctor about taking pentoxifylline. Some people benefit from taking the medicine pentoxifylline (Trental) three times a day in addition to using a compression bandage. This medicine improves blood flow in your veins and arteries. Pentoxifylline can make you feel dizzy or sleepy, so know how it affects you before driving. Talk to your doctor about your other medications and health conditions to find out if this medication is right for you.
   • Tell your doctor if you have kidney problems, take any blood thinners, are pregnant or want to get pregnant, have an upcoming surgery, or are allergic to caffeine.
6. Discuss aspirin therapy with your doctor. Talk to your doctor about whether taking aspirin may help your condition. You may take 300mg of aspirin daily, which is safe for most people.
   • This may speed up your healing time if you also use your compression bandage.
7. Consider surgery if your ulcer doesn’t heal in six months. Most ulcers heal with proper treatment. However, if your treated ulcer does not heal after six months, you may need a surgical procedure. Discuss these options with your doctor:
   • Surgical “debridement” is scraping away dead tissue in the ulcer, which can help promote healing.
   • Skin grafting can improve healing of really large ulcers, and involves covering the ulcer with skin from your own body, from someone else, or with artificial skin. This won’t help if you have a lot of swelling, though.
   • Other surgeries are on the veins themselves, to improve blood flow.

Altering Lifestyle Practices

1. Elevate your leg every day. Sit or lie down and elevate your leg so that your toes are at your eye level or higher. This improves blood flow and helps to heal ulcers. Do this three to four times every day for at least 30 minutes.
   • Elevate the end of your bed about six inches, so that your leg is elevated while you sleep. You can use boxes or books for this.
2. Wear compression stockings to manage swelling. If you have venous ulcers, you may also have swelling in your feet and legs. Wearing compression stockings can help this. Compression stockings differ from the compression bandage you wear while your ulcer heals, because you can take stockings on and off. Request compression stockings from your doctor or pick some up at your local drug store or pharmacy. Ask your doctor the following questions:
   • How many hours a day should I wear my stockings?
   • Should I take them off at any point in the day?
   • When shouldn’t I wear them?
   • Can I wear them while my ulcer is still healing?
   • What size and tightness should I wear? (If you don't get them from the doctor directly)
3. Stay as active as possible. Walk every day. Do ankle rotations and raise and lower your foot when you’re sitting. Get as much exercise as you’re able. This will improve your circulation and help heal and prevent ulcers.
   • Standing still and sitting without elevating your leg can make swelling worse.
   • Talk to your doctor before starting any exercise regime to find out what's safe for you.
4. Use moisturizer for itchy skin. Your skin may feel itchy if it doesn’t get good blood flow. Do NOT scratch it – this can damage your skin and cause more ulcers! Use regular moisturizing lotion on dry, itchy skin.
   • If that doesn’t help, ask your doctor for recommendations – they may give you a steroid cream to improve the itchiness.
   • Keep your skin well moisturized to prevent breaks in the skin that can turn into ulcers. Do not put lotion on an open wound or between your toes, however.

Tips

• Venous ulcers should heal within 3-4 months with proper treatment.
• Wear comfortable shoes that fit you well to avoid blisters that can turn into ulcers.
• Stop smoking and drink very little alcohol or none at all. This will help your health and circulation.
• Wear your compression stockings after your ulcer heals to help prevent new ulcers from forming.

Warnings

• It’s important to get your ulcers treated right away. Leaving them untreated can cause serious medical problems like bone infections and cancerous changes.
• Lifestyle changes will help your ulcer heal, but wearing the compression bandage is the most important thing you can do.
• Visit your doctor right away if your ulcer starts to hurt more and leak discharge or pus. It may be infected and you may need antibiotics. Take antibiotics exactly as directed. An infected ulcer won’t heal!

Sources and Citations

See also

• Heal a Skin Tear
• Care for a Bandage or Splint on a Cat
• McConnell Tape Your Knee
• Untrap a Nerve in Your Elbow
• Rehab a Sprained Ankle
• Heal Scabs on Your Face
• Heal Scratches
• Heal a Split Lip
• Tape an Ankle Like an Athletic Trainer
• Remove a Deep Splinter

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