Ask the Treatment Expert ... about leg sores

Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC

How do you handle people obsessed with leg sores?

First, remind them that all ulcers are not pressure ulcers.

There are three major types of ulcers that occur on the lower legs and feet. The majority of lower leg ulcers are venous, frequently referred to as venous stasis ulcers. Arterial ulcers are also noted on the lower legs and feet. Diabetic or neuropathic ulcers are commonly located on the plantar aspect of the feet, but trauma such as friction from footwear may cause ulcers to form on other areas of the feet.

Venous leg ulcers are superficial wounds usually localized in the mid-calf area. These ulcers present with irregular edges, are usually moist, and edema is frequently present. The skin surrounding the wound may be discolored and visualized as a brown or a darker skin color due to blood leaking into the tissue.

Arterial ulcers are due to a disruption of peripheral blood flow via the arteries to the lower extremity. These are ischemic areas. The skin surrounding the wound will appear shiny, thin and pale. The wound will be deep and have very defined borders with a pale and dry wound bed.

Diabetic foot ulcers are usually located on the sole of the foot but may also be present on the top or sides of the foot. These are due to repetitive pressure and shear. They are frequently caused by footwear. Ulcers located on the sole of the foot are frequently surrounded by a thick callus with a dry, pale wound bed. If these indications are noted, a diabetic or neuropathic ulcer should be suspected.

Of course, as with any wound or ulcer, the physician should be consulted immediately for additional diagnostic evaluation, preventive strategies, and development of a treatment plan. Because these ulcers have a different etiology, they should never be staged as pressure ulcers.