An ulcer is simply a break in the skin of the leg, which allows air and bacteria to get into the underlying tissue. This is usually caused by an injury, often a minor one that breaks the skin.
In most people such an injury will heal up without difficulty within a week or two. However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size. This is a chronic ulcer. If the reason for the ulcer not healing is poor circulation due to blocked arteries in the leg, (atherosclerosis) we call it an ARTERIAL ULCER.
Arterial ulcers are often very painful, they are often on the foot, around the ankle, sometimes the lower leg. The pain from them can be worse at night, and patients hang the leg out of bed or sleep in a chair to get relief from this night pain. they are prone to infection, so antibiotics are often needed, but treating the infection alone will not heal the ulcer in most cases. For many of these non-helaing, painful ulcers, urgent treatment is needed to improve the blood supply to the ulcer. With a better circulation the pain often improves quickly and the ulcer can start to heal.
There are many dressing used to help leg ulcers heal, keeping them clean and protected. Some will aim to reduce discharge, some will try and help old tissue or slough lift off alowing the healthy tissue to come through. Although the type of dressing can be helpful, in arterial ulcers it is important not to miss the opportunity to improve the blood supply if possible. This will be more effective than any change of dressing for an arterial ulcer. Diabetic foot ulcers are a related form of ulcer. For information about those look on the conditions list.
To improve the blood supply to the ulcer an angioplasty is often used, or surgery to clear out a blockage from a leg artery (endarterectomy) or a bypass operation to put in a new route for blood flow in the leg.
For more information on these treatments look in the Procedures section