Legs chronic ulcers: what to do?

Good morning everyone,

I have been suffering from legs ulcer for 14 years. I don’t have diabetes; circulation is good even though a small saphenous vein obstruction was diagnosed. I should have surgery but only if ulcers heal.

Despite 3-weeks medications, I haven’t seen any improvement and I can’t even manage to go to work and undertake physical activity.

Vulnology believes it is neuropathy and wants to provide me with a treatment. I also take tolep for the epilepsy, although I didn’t have any more crises.

Waiting for your kind reply,



One comment on “Legs chronic ulcers: what to do?

  1. Ilaria Succi on

    Good morning Cristian,
    Thank you for contacting us. I’m so sorry for your current situation. As you explain to us, amplified by the small saphenous vein obstruction, it is highly probable that it is a ulcer of venous etiology that comes out in a condition of venous insufficiency.
    The venous system must bring refluent blood back from tissues to the heart. In legs, when discharge is slowed or obstructed, pressure increases: there is a stasis of blood and lymph with swollen legs. This condition impedes oxygen and nutrients in the blood to perform their physiological function of tissues nourishment and wound healing. When legs swell a lot, skin loses its elasticity and lacerates, thus causing an “unpleasant” venous ulcer.
    How can a similar condition be faced?
    Before speaking about ulcer therapy it is necessary to confirm or rule out the presence of venous insufficiency through the Ecocolordoppler diagnostic procedure, which allows checking up legs on the venous and arterial sides to understand the origins of the problem.
    Once the report of the ecocolordoppler is obtained, which confirms venous disease, you move to the compression bandage, which is the first choice in wounds lower limbs treatment. Indeed, it compresses legs liquids by squeezing them to the internal circulation, thus diminishing internal leg pressure and swelling itself, which is one of wounds main cause. Wounds healing occur with skin migration from the outside to the inside of the wound and it fulfils only when there is a healthy tissue where the right quantity of blood and nutrients arrives. Therefore, the main goals are: legs deflation, venous pump increase, absorption of the liquids, oxygen supply and useful for healing nutrients increase.
    When it comes to our patients’ pathway with legs ulcers, a visit with a doctor and specialized nurse is scheduled in order to detect general and specific parameters to ulcer’s classification and their general clinical condition:
    – Vital signs survey (arterial pressure, heart rate, blood sugar, haemoglobin and saturation).
    – Little knowledge of patient’s history (concomitant diseases, medicines taken, allergies, intolerances, diet and lifestyle)
    – ABI measurement: ankle/arm pressure ratio. If < 0.9 it shows that there is a problem of arteriopathy, that is to say of blood flow to the extremities. - Transcutaneous oximetry (TcpO2): a non-invasive methodology to measure oxygen partial pressure in ulcers area. It is useful to establish healing probabilities and provisions on the basis of the pathway to be followed. - Laser Doppler Flowmetry: non-invasive method that provides information on tissues perfusion and on the microcirculation residual capacity to respond to specific stimuli. - Other surveys (wound mapping, Falanga method, pH, etc.) to decide which medications to use and to determine their frequency. - Lastly, you talked me about this pain, which is a top priority aspect not to underestimate. We will examine it in depth with specialist exams and multidisciplinary evaluations to understand the cause and to deal with it in the most suitable manner for your clinical condition, intervening on pharmacological aspect, behaviours to adopt at home and medications to take in order to reduce it. For pain reduction, the Hyperbaric Centre of Ravenna established new care pathways with the use of FREMSTM technology (Frequency Rhythmic Electrical Modulation System) that works without side effects, reducing or totally eliminating the use of medicines. For more information on FREMSTM therapy, please read the articles we published on this topic. I hope I have satisfied your request. Best regards, Ilaria Succi Nurse of the Wound Care Centre of the Hyperbaric Centre of Ravenna.


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