March 19, 2010

Treatment and Causes for Ankle Ulcer

Posted in Category : Common Ailments

Ankle ulcer is an open wound that is recurrent in nature and difficult to heal. Ankle ulcers are often caused by improper circulation, diabetes, and other leg complications. The three predominant types of ankle ulcers are

  • Venous stasis ulcer
  • Arterial ulcer (ischemic)
  • Neurotrophic (diabetic)

Venous leg ulcer or venous stasis leg ulcer is the most common leg ulcer and accounts for 90% of all leg ulcer cases. Venous leg ulcers mainly appear above the ankle, on the side or on back of the leg. Venous leg ulcers are mostly pain free, but lack of treatment may cause serious complications in the leg.
Non-venous ulcers are not common and may be caused by improper circulation, complications with nerve supply, or some other conditions. The treatment approach for non-venous leg ulcer is different from that of venous leg ulcer.

Causes: Under normal circumstances, healthy veins let the blood flow from the legs up towards the heart and stop the backward flow. However, damaged valves in the leg veins are unable to stop the backward flow of the blood. The excess pressure of blood in the veins of the leg causes the fluid to accumulate beneath the skin. This results in thickening and swelling of the skin. In course of time, the damage caused to skin results in the formation of an ulcer. Some other causes of venous leg ulcer are:

  • Hypertension
  • Varicose veins
  • Deep Vein Thrombosis (DVT)
  • Past history of leg swelling
  • Surgery
  • Injury or fracture
  • Obesity
  • Multiple pregnancies
  • Ageing
  • Inactivity or immobility

Treatment: The investigation for the venous leg ulcer includes:

  • Doppler for ankle brachial pressure index ( ABPI) (for arterial ulcer)
  • Swabs (to check infection )
  • Patch rest (leg ulcer series)
  • Biopsy (for severe cases)

The treatment for venous leg ulcer includes the following options.

  • Compression: The compression bandage or elastic medical compression stocking is one of the most efficient treatment methods of venous leg ulcers. The compression checks the damaged veins, boosts circulation, and reduces the collection of blood in the lower leg. The duration of the compression treatment depends upon the condition of the wound.
  • Ulcer Dressings and Wound Care: The topical dressings on the venous leg ulcer help heal the damaged tissue. The dressings are usually clear, transparent plastic like films that are changed every four to five days.
  • Debridement: Debridement is the surgical removal of damaged, dead and infected tissue from a wound. The ulcer is debrided to avoid serious complication like severe pain and sepsis, which may result in the amputation of the lower leg.

Some other treatment methods for ankle leg ulcer include:

  • Antibiotics
  • Painkillers
  • Blood circulation drugs like pentoxifylline
  • Skin grafting
  • Surgery for varicose veins or other conditions

Home Remedies: Some of the effective home remedies for ankle ulcer are as follows:

  • Clean the wound and keep it dry
  • Elevate legs and increase mobility
  • Quit smoking
  • Drink plenty of fluids
  • Keep blood pressure in control
  • Include fresh vegetables and fruits in the daily diet
  • Take prescription medication as advised
  • Change the dressing on the wound regularly
  • Exercise regularly
  • Wear suitable shoes
  • Use compression wraps as directed by the physician
  • Keep a check on blood cholesterol and triglyceride levels
  • Limit salt intake
  • Keep blood sugar levels and other medical conditions in check
  • Manage the weight
  • Take medication to prevent blood clots in consultation with the physician

Herbal Remedies: There are several anti-inflammatory herbs that relax the damaged nerves and reduce the pain.  Some of the herbs that may help to heal the ankle ulcer are as follows:

  • Comfrey contains plant chemicals like allantoin, rosmarinic and mucilage that have anti-inflammatory and healing properties.
  • Witch hazel is rich in tannins, which have antiseptic, astringent, hemostatic and anti-inflammatory properties.
  • Gotu kola, also known as Centella asiatica, is used in various anti-inflammatory and pain relieving creams and ointments.

Home and herbal remedies may assist in the healing of the wound and may reduce the pain; however, consult a physician or a qualified health practitioner before starting with any alternate treatment.