LEG AND FOOT ULCERS

Finding the Root Cause of Lower Extremity Ulcers

Leg and foot ulcers affect millions of people, causing significant pain, reduced quality of life, and a risk of amputation. The key to successfully treating these ulcers is identifying and addressing the underlying cause.

 

Definition

Over 85% of lower extremity ulcers are caused by underlying vascular problems, such as peripheral artery disease (PAD) or chronic venous insufficiency (CVI). These conditions can impair blood flow to the legs and feet, making wound healing difficult.

Risk Factors

What are some of the risk factors for developing leg and foot ulcers?

  • Age
  • Gender (leg ulcers are more prevalent in women)
  • Smoking
  • Diabetes (diabetic foot ulcers)
  • Obesity
  • Poor nutrition
  • Trauma
  • Sedentary work or lifestyle
  • High cholesterol
  • History of Deep Vein Thombosis or varicose veins
  • High blood pressure
  • Kidney disease or failure
  • Family history of vascular disease

Symptoms

What are some of the symptoms?

  • Leg or foot sores that aren’t healing, or show no signs of healing or are healing very slowly
  • Swelling in ankles or legs
  • Burning
  • Rashes, or redness
  • Skin discoloration
  • Unpleasant smell or discharge
  • Hardened, flaky, itchy, or scaly skin

Treatment and Benefits

Unfortunately, many patients with lower extremity ulcers do not receive adequate vascular evaluation, leading to ineffective treatments and poor outcomes. Every patient with a lower extremity ulcer at VIE undergoes a thorough vascular assessment. Our team of vascular specialists uses state-of-the-art diagnostic tools to identify the root cause of your ulcer, including:

  • Comprehensive medical history and physical examination
  • Ankle-brachial index (ABI) and toe-brachial index (TBI) to assess arterial blood flow
  • Venous duplex ultrasound to evaluate venous function and identify reflux or obstruction
  • Advanced imaging, such as CT or MR angiography, when needed

By accurately diagnosing the underlying vascular issue, we can develop a personalized treatment plan to promote healing and prevent recurrence.

Alarmingly, nearly 50% of patients who undergo a major amputation due to a lower extremity ulcer did not receive an adequate arterial evaluation beforehand. At VIE, we are committed to changing this statistic.

Our vascular specialists use a combination of non-invasive tests and advanced imaging to assess arterial blood flow and identify areas of blockage. When needed, we offer minimally invasive treatments, such as angioplasty or stenting, to improve circulation and promote healing. We provide the highest level of care for patients with lower extremity ulcers. Our multidisciplinary team includes vascular surgeons, interventional radiologists, and wound care specialists who work together to develop personalized treatment plans based on each patient’s unique needs. We offer advanced wound care therapies, such as bioengineered skin substitutes and negative pressure wound therapy, in addition to targeting the underlying vascular issues.

  1. Duff, S., Mafilios, M. S., Bhounsule, P., & Hasegawa, J. T. (2019). The burden of critical limb ischemia: a review of recent literature. Vascular Health and Risk Management, 15, 187–208. https://doi.org/10.2147/VHRM.S209241
  2. Mooij, M. C., & Huisman, L. C. (2016). Chronic leg ulcer: does a patient always get a correct diagnosis and adequate treatment? Phlebology, 31(1 Suppl), 68–73. https://doi.org/10.1177/0268355516632436
  3. Vemulapalli, S., Greiner, M. A., Jones, W. S., Patel, M. R., Hernandez, A. F., & Curtis, L. H. (2014). Peripheral arterial testing before lower extremity amputation among Medicare beneficiaries, 2000 to 2010. Circulation: Cardiovascular Quality and Outcomes, 7(1), 142–150. https://doi.org/10.1161/CIRCOUTCOMES.113.000376