Leg and Foot ulcers
Leg and Foot ulcers
Evaluate before you amputate
What is an ulcer?
An ulcer is an open wound in the skin that does not heal after a few weeks.
What causes leg and foot ulcers?
Over 85% of leg and foot ulcers are caused by vascular problems.1–3 Ulcers on the calf and ankle are often caused problems with veins while ulcers on the foot are often caused by blocked arteries. Correctly diagnosing a leg or foot ulcer requires seeing a physician with expertise in blood flow problems in the leg and foot.
Why are leg and foot ulcers a problem?
Untreated or incorrectly treated ulcers cause significant pain and can result in drastically worse quality of life. In some instances, ulcers can lead to amputations of the leg or foot.
What is the Amputation Lottery?
At VIE, we are on a mission to prevent limb amputations whenever possible. We empower people to “evaluate before you amputate.”
Unfortunately, care in the United States today can be characterized as a "Pathway to Amputation."4 Too often, more than 70% of the time in fact, patients do not receive the best vascular care prior to a major amputation. 5
Numerous studies have shown that the probability of undergoing a major amputation depends on who you are, and where you live. In other words, if you will succumb to the "Amputation Lottery." 6,7
Additionally, hospitals are limiting referrals to outside specialist care, like what we provide at VIE. See: "Leakage versus Keepage." 8
What are the treatment options for leg and foot ulcers?
The first step is to determine why you have an ulcer. A leg or foot ulcer is a symptom of an underlying condition. Often, a leg or foot ulcer does not heal because of multiple reasons including poor circulation, neuropathy, infection, local pressure, and poor nutrition.
Once the cause of the ulcer is determined, the correct treatments are determined.
Treatment may include:
- Opening blocked arteries (revascularization)
- Closing abnormal veins (ablation and sclerotherapy)
- Debridement (removing dead tissue)
- Appropriate ulcer dressing
- Application of skin substitutes
- Compression of swollen legs
- Offloading of pressure
- Nutritional support
- Control of infection
Why do I need VIE expertise?
Lower extremity wounds are complex and challenging for patients, families, and healthcare
providers. Most lower extremity ulcers are secondary to either arterial or venous problems. A comprehensive history and physical assessment followed by appropriate imaging are essential to identifying, diagnosing, and developing care plans.
Dedicated vascular specialists like VIE should be involved in the care of all lower extremity ulcers and wounds to determine or exclude the presence of significant arterial or venous disease.9,10 Continuous advances in endovascular therapy from pedal artery intervention to arterialization of the venous system are improving outcomes and limb preservation rates (Figure 1).
Rapid referral and treatment of the underlying problem improves wound healing rates, reduces patient morbidity, and enhances life quality.11–14
Figure 1. Endovascular reconstruction of the pedal loop and plantar arteries.
What ulcer/wound care treatments does VIE provide?
VIE offers advanced wound care treatments, including:
- Skin substitute and biologic grafting
- Advanced wound dressing
- Wound infection prevention
- Compression wraps
- Negative pressure therapy
VIE provides truly integrated care. We combine expertise in diagnosis, state-of-the-art vascular procedures and treatments, optimal medical management and coordination, and local ulcer care to heal your ulcer quickly.
What can I expect from VIE?
Here's what you can expect from your visit:
- CONSULTATION: Symptom review and health history discussion.
- TESTING: Expert evaluation of the blood flow into the leg and foot and blood flow out of the leg and foot.
- IMAGING: Appropriate imaging of the arteries and veins in the foot and leg using ultrasound and CT scanning
- TREATMENT PLAN: A comprehensive review of all symptoms, exams and imaging enable Dr. Wolfe and Dr. Cumming to provide definitive treatment recommendations.
Take the first step toward healing.
Call to schedule