Dr. Nikhil Bansal

What are leg ulcers?

Leg ulcers are open wounds or sores that develop on the skin of the legs. They can vary in size and depth and are often slow to heal. Leg ulcers can be caused by various underlying conditions, such as poor circulation, venous insufficiency (where the veins fail to properly return blood to the heart), arterial disease (which affects blood flow through the arteries), diabetes, and sometimes even trauma or injury to the leg.

Venous leg ulcers are the most common type, usually occurring due to problems with the veins in the legs, which can lead to pooling of blood and increased pressure in the veins. This pressure can cause damage to the skin and tissues, leading to the development of ulcers. Arterial leg ulcers, on the other hand, result from poor blood flow in the arteries, often due to conditions like peripheral artery disease.

Symptoms of Leg Ulcer

The symptoms of a leg ulcer can vary depending on the underlying cause, but common signs and symptoms include:

• Open wound or sore: Leg ulcers typically present as open sores on the skin of the legs. These ulcers may vary in size and depth.
• Pain or discomfort: The ulcerated area may be painful, especially if the nerves in the skin are affected. The pain can range from mild to severe and may be constant or intermittent.
• Swelling: Swelling (edema) may occur around the ulcerated area due to poor circulation or fluid buildup in the tissues.
• Redness or discoloration: The skin surrounding the ulcer may appear red, inflamed, or discolored. In some cases, the skin may take on a brownish or purplish hue.
• Warmth: The skin around the ulcer may feel warm to the touch due to inflammation or increased blood flow to the area.
• Itching or irritation: Some people with leg ulcers may experience itching or irritation around the affected area.
• Drainage or discharge: Leg ulcers may produce fluid or pus, which can ooze from the wound. The drainage may vary in color and consistency.
• Slow healing: Leg ulcers typically heal slowly and may not show signs of improvement without proper treatment.

What are the causes of leg ulcers?

Leg ulcers can arise from various conditions, including:

• Chronic Venous Insufficiency: This condition occurs when defective valves in the leg veins allow blood to flow backward, pooling in the legs. Elevated pressure in the leg veins can rupture tiny blood vessels (capillaries), resulting in inflammation, itchiness, and dry skin. When the skin breaks open, leg ulcers may form.
• Diabetes: High levels of blood sugar in diabetes can lead to the accumulation of fat deposits within blood vessels, causing them to narrow. Reduced blood flow can result in nerve damage, known as diabetic neuropathy. Individuals with this condition may not feel or be aware of the presence of a leg ulcer. Additionally, diabetes slows down the process of wound healing.
• Peripheral Artery Disease (PAD): PAD involves the buildup of plaque (fatty deposits) in the arteries (atherosclerosis). This leads to narrowing of the blood vessels in the legs, impeding proper blood circulation. Consequently, the slowed blood flow hampers the healing of leg ulcers. People with diabetes have a higher risk of developing PAD.
• High Blood Pressure: Chronic and inadequately managed high blood pressure (hypertension) can cause the formation of an excruciatingly painful ulcer on the lower leg known as a Martorell ulcer. High blood pressure leads to the narrowing of capillaries in the skin, which restricts blood supply to the skin. In severe cases, skin tissue may die, resulting in the formation of a leg ulcer.

What are the factors that increase the risk of leg ulcers?

Several factors can elevate the likelihood of developing leg ulcers, including:

• Gender: Women are twice as likely as men to develop leg ulcers.
• Weight: Extra weight due to obesity or pregnancy can increase the risk.
• Family history: Having a family history of vein problems can predispose individuals to leg ulcers.
• Health conditions: Conditions such as diabetes, high blood pressure, and rheumatoid arthritis are associated with a higher risk.
• Surgical procedures: Undergoing hip or knee replacement surgeries can elevate the risk of leg ulcers.
• Injuries: Traumatic accidents, including broken bones, can contribute to the development of leg ulcers.
• Physical inactivity: Lack of physical activity, including paralysis, can increase susceptibility.
• Smoking: Smoking is a risk factor for leg ulcers.
• Venous conditions: Varicose veins, vasculitis (inflamed blood vessels), and venous blood clots (thromboembolism) are also linked to a higher risk of leg ulcers.

How are leg ulcers managed?

Addressing leg ulcers can be a prolonged process, often persisting for months or even years despite treatment efforts.

Treatment approaches vary based on the type and underlying cause of the ulcer. Healthcare providers focus on wound healing, reducing swelling, and preventing recurrence as the ulcer heals.

Common treatments for leg ulcers include:

• Compression therapy: Utilizing stockings or bandages to enhance blood flow in the legs.
• Leg elevation: Raising the legs above heart level for at least one hour daily over a span of at least six days.
• Wound care: This involves procedures like debridement (removal of dead skin tissue by a healthcare provider), application of topical antiseptics to prevent infection, and regular bandage changes.
• Hyperbaric oxygen therapy: Administered to increase oxygen levels in the blood, promoting faster healing.
• Sclerotherapy or endovascular ablation: Techniques used to address underlying issues like varicose veins.
• Surgery: Involves procedures to remove, repair, replace, or bypass damaged veins.

Why Choose Dr. Nikhil Bansal (Interventional radiologist) For Leg Ulcer Treatment?

Choosing Dr. Nikhil Bansal, an Interventional Radiologist, for leg ulcer treatment offers several advantages:

Specialized Expertise: Dr. Bansal possesses specialized knowledge and skills in interventional radiology, making him uniquely qualified to address the underlying vascular issues contributing to leg ulcers.

Advanced Techniques: As an interventional radiologist, Dr. Bansal can utilize advanced minimally invasive procedures to treat conditions such as varicose veins or arterial insufficiency, which are common underlying causes of leg ulcers.

Personalized Care: Dr. Bansal provides individualized treatment plans tailored to each patient’s specific needs and medical history, ensuring optimal outcomes and personalized care throughout the treatment process.

Comprehensive Approach: Dr. Bansal takes a comprehensive approach to leg ulcer treatment, addressing not only the wound itself but also the underlying vascular issues to promote long-term healing and prevent recurrence.

Overall, choosing Dr. Nikhil Bansal for leg ulcer treatment ensures patients receive expert care, advanced techniques, and personalized attention to effectively manage their condition and improve their quality of life.