Ulcus cruris or open leg

Ulcus cruris or open leg

An ulcus cruris or open leg is an ulcerated wound on the lower leg. The wound is usually on the inside of the lower leg. The wound is often not very painful, but it can secrete a lot of moisture and smell very bad. The cause is usually a problem in the veins of the leg. Ulcus cruris mainly occurs in old age, it is hardly seen under the age of 45. It is more common in women. Before an open leg develops, abnormalities have been visible on the leg for a long time, such as swelling, varicose veins, and brownish discoloration of the skin.

Symptoms of an ulcus cruris (open leg).

Before an ulcus cruris or open leg develops, complaints and changes are already visible on the leg. This is due to pressure increase in the veins of the lower leg as a result of reduced drainage. The first symptom is often a heavy, tired feeling in the legs. During the day, the ankles swell. The veins in the leg can swell and become visible (varicose veins). The skin becomes thinner and more fragile. There are also brown and eczema spots visible. Minor damages can quickly turn into wounds that are difficult to heal (ulcus cruris).

Ulcus cruris (open leg) How does it occur?

The cause of the open leg is usually a disorder in the return of blood to the heart. The veins in the leg contain valves. When walking, the muscles ensure that the blood is pumped back towards the heart. Properly functioning valves are necessary for this. Sometimes the valves don’t close properly. The blood then flows back and creates a higher pressure in the tissues around the ankle. This causes changes in the skin and underlying tissue. The skin becomes more vulnerable and ulcus cruris may develop. Reduced blood flow due to narrowing of the arteries in the leg can also cause wounds. In this case, the wounds are mainly on the feet and legs.

Ulcus cruris (open leg), is it serious what can you expect?

A leg ulcer can have serious consequences. The wound can become infected. From the wound, bacteria can enter the bloodstream and cause a serious infection. The healing of an ulcus cruris (open leg) takes a long time. Wound treatment and outpatient compression therapy are the mainstays of the treatment. The wound is cleaned and dead tissue removed. The wound should not be too dry or too moist. Ensuring a good moisture content of the wound is done with special wound dressings.

The wound treatment is pointless without outpatient compression therapy. The leg is then bandaged. The leg shrinks and blood is more effectively pumped back to the heart. In the beginning it is often necessary to bandage daily, especially if there is a lot of wound fluid. This can be gradually reduced to twice a week. The bandages remain in place day and night.

It is very important to walk and move, this stimulates blood flow. The calf muscle pump is also activated by exercises of the calf muscles. At rest, the legs should be raised slightly to prevent swelling. Sometimes it may be necessary to use additional medicines such as antibiotics and painkillers.

Healing takes a long time. After three weeks of treatment, the start of healing is already visible. The wound is smaller and less deep. New skin grows over the wound from the wound edges. Still, it can take many months for the wound to heal. It is important to keep wearing an elastic stocking afterwards. The GP refers to the specialist if no improvement is visible even after 2 months. Sometimes the wound can be so large that surgical closure of the wound is required.

When to go to the doctor with an ulcus cruris (open leg)?

It is always advisable to visit a doctor with wounds on the lower legs or feet that have little tendency to heal. He will determine the most likely cause on the basis of your complaints and the physical examination. Sometimes additional vascular examination is necessary. In case of a disorder in the function of the veins, he starts treatment with ambulatory compression therapy. If you have a deep wound or if you suspect another cause, you will be referred to a specialist.

What can you do about an ulcus cruris (open leg)?

During treatment for a leg ulcer with ambulatory compression therapy, movement is very important, walk a lot. If necessary, use a walker. Also do exercises to stimulate the pumping action of the calf muscles. You do this by standing with both feet on the toes. Raise the legs while resting. Wear elastic stockings daily after compression therapy is finished.

General advice and precautions

Regular exercise (walking, cycling, swimming) is important in the prevention of leg ulcers. Do not wear tight clothing, such as tight knee socks. Do not stand still for too long and use a support under the feet when sitting. Also make sure you have well-fitting, non-restrictive shoes. It is better not to use high heels. Healthy food and weight are beneficial. Smoking is disadvantageous. Try to avoid cuts to the lower legs.

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