About this condition
A venous ulcer often develops on the lower leg near the inner ankle when venous pressure remains elevated over time. The wound may be painful, weep and heal slowly. Not every leg ulcer is venous: arterial disease, neuropathy, infection and other conditions can produce similar-looking wounds.
Why healing can be difficult
Long-standing venous hypertension contributes to swelling, inflammation and skin damage. A minor injury can become a persistent wound, and ulcers may recur after healing. Venous ulcers are recognised complications of venous disease, but the appropriate treatment is not necessarily a particular surgical procedure.
Why both veins and arteries matter
The clinician examines the wound, skin, swelling and signs of infection. Duplex ultrasound can help assess reflux or previous thrombosis. Before therapeutic compression, arterial circulation needs to be adequate; an ankle-brachial pressure index may be measured when indicated.
A comprehensive wound-care plan
Care can involve appropriate dressings, professional wound management, individually selected compression after arterial assessment, and treatment of underlying venous disease where indicated. Antibiotics are reserved for clinically infected wounds rather than prescribed solely because an ulcer exists. Healing time varies.
Signs and symptoms
- A persistent wound on the lower leg that heals slowly.
- Ankle swelling and darkened or hardened skin around the wound.
- Weeping, discomfort or itching; infection may cause increasing discharge and odour.
A non-healing wound is not automatically venous; infection and arterial insufficiency must also be considered.
Diagnosis and tests
Assessment includes the ulcer, its duration and healing trend, swelling, venous disease and arterial circulation. Duplex ultrasound may identify reflux or post-thrombotic changes. An ankle-brachial index can guide safe compression. Atypical ulcers may require additional tests for other causes.
Care and treatment approaches
Treatment may include professional wound care, suitable dressings, safe compression after assessment of arterial flow and management of venous disease when indicated. Antibiotics are prescribed for clinical infection. Do not apply tight compression bandages to an unexplained ulcer without medical advice.
When to seek urgent care
Seek urgent care if pain, redness, warmth or wound discharge increases rapidly, there is foul odour or fever, or general health deteriorates. A suddenly cold, pale foot or severe limb pain requires emergency assessment.
Frequently asked questions
Can a venous leg ulcer heal with ointment alone?
Usually not. Identifying the cause, assessing circulation and planning comprehensive care are essential. Self-treatment can delay healing.
Are compression bandages safe for everyone?
No. Arterial circulation and contraindications must be assessed before therapeutic compression. The required pressure is individual.
Does every leg ulcer need antibiotics?
No. Antibiotics are used when there are clinical signs of bacterial infection and an appropriate medical indication.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
