Leg Wounds (Ulceration)

Leg Wounds (Ulceration)

Leg wounds are a common and difficult problem. Having a chronic leg wound can significantly affect quality of life and affect a person’s wellbeing.

Of all leg wounds, 70% are from vein problems although this is often not recognized nor managed properly.

Some are from other vascular causes – like blocked arteries, with resultant decreased oxygenation of the tissue. In addition, there are other causes such as trauma, infection and microvascular causes.

In terms of vein problems, there has been more research understanding venous disease and why some people end up with damaged and pigmented skin, eczema and wounds. This is thought to be partly due to increased venous pressure, actually starting from the pelvic veins and putting extra strain on the legs. It has also been noticed that the microcirculation is affected, with dilated small veins, not able to carry blood properly.

Wounds may also develop after patients have had deep vein thrombosis. This is often associated with leg swelling and skin damage. This is known as Post Thrombotic Syndrome and this needs a complete vein assessment and intense management.

All patients with deep vein thrombosis should be on a prevention programme for Post Thrombotic Syndrome. We run this with the lymphoedema therapists along with treatment programmes for those suffering Post Thrombotic Syndrome.

Anyone with a leg wound should have a full vascular assessment to assess the arteries and veins.

A nutritional assessment should also be done as optimal vitamin levels are vital to wound healing.

Dr Redman is part of the Cape Advanced Wound Care Clinic at Christiaan Barnard as well as on the editorial board for the Wound Healing South Africa.

She is also the founder member of Limb 4 Life – a multidisciplinary team with an approach to all limb problems and treating a patient holistically.

Sr Paddy has completed a course in compression bandaging.

Before and after venous procedures, Sr Paddy will help with wound care and management, compression and advice with the greatest of care. Sr Paddy has great compassion and care for patients. She will assess patients holistically and help with dressings, compression and lifestyle changes that are suitable to each individual rather than following a set medical protocol. She has many a time been described as an ‘angel’ and is the Florence Nightingale of this era.