To speak of “vascular ulcers” is to speak of poorly healed wounds located on the leg. And in the vast majority of cases, almost 90%, they are motivated by poor circulation.
As for its consequences, the ulcers in the legs are a serious public health problem.
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They have a huge impact on people’s quality of life.
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They limit mobility
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They are at high risk of infection
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In extreme cases they can even lead to amputation.
The prevalence of vascular ulcers is not negligible. They are present in 3% of the adult population, mostly affecting patients over 60 years of age.
According to the head of Angiology and Vascular Surgery at Hospital Ruber Internacional, doctor Paul Gallothe cause of the appearance of ulcers is blood circulation problems, either caused by diseases of the veins or arteries, or, in some cases, by both conditions.
Venous ulcers
As Dr. Gallo points out:
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“Venous ulcers represent between 80-85% of vascular ulcers, and are one of the complications of chronic venous insufficiency, that is, varicose veins that have not been treated early,”
This specialist warns that chronic venous insufficiency can manifest with discomfort in the legs such as:
- Sensation of heaviness or pain.
- Cramping or tingling sensation.
- They may also have swelling.
- Thick and/or thin varicose veins.
- Changes in skin color.
“Over time the skin also weakens and becomes susceptible to wounds that do not heal and can progress to an ulcer,” he says.
All these symptoms increase in people who, due to their way of life, remain on their feet for a long time. And they are also exacerbated in the hottest months.
Arterial ulcers: diagnosis
As Dr. Gallo explains, ulcers that do not heal or that heal and reappear may be due to an arterial problem.
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«Arterial ulcers represent 10-25%, mainly affecting people over 50 years of age and is more common in the male population, in women the prevalence usually increases at age 65. That is why it is so important that they be evaluated by a vascular pathology unit, to identify if the lesion is of venous or arterial origin”, indicates the doctor.
The diagnosis is obtained by taking a complete clinical history to identify risk factors, accompanied by a thorough physical examination of the lower limbs, identifying, among other issues:
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skin integrity
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Presence of injuries
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Circulation Assessment
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of sensitivity
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of temperature
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Coloration.
Regarding the diagnostic tool, as stated by the doctor santiago zubicoaresponsible for the Interventional Vascular Radiology Unit of Hospital Ruber Internacional. The most used is:
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“He echo-dopplerbecause it is the tool that provides us with important information about the blood circulation. In some cases, to identify the degree of affectation, a arteriography or other imaging tests”,
Prevention, the best treatment of ulcers
Since the best way to cure them is to prevent them from coming out, treatment for vascular ulcers should be aimed at prevention. For this reason, Dr. Gallo recommends treatment before the ulcer appears on the legs or feet.
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“To prevent venous ulcers, venous insufficiency (varicose veins) must be treated, and we currently have minimally invasive methods that are performed without making incisions and are treated endovascularly, as is the case with radiofrequency.”
As explained by Dr. Zubicoa, when peripheral arterial disease is established, a detailed study must be carried out to determine if the treatment should be conservative or if it is necessary to perform endovascular treatments to get more blood to the legs.
And it is that, as the head of the Angiology and Vascular Surgery Unit of Hospital Ruber Internacional acknowledges:
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“Good blood glucose control, added to healthy lifestyle habits, foot care and a good choice of footwear, are the key to preventing injuries,”
“In extreme cases where there is no possibility of getting blood or in the presence of osteomyelitis (bone infection), and/or necrosis of the toes or the entire foot, amputation will be indicated,” concludes Pablo Gallo.