There are a great many people in the community suffering needlessly from constant dressings and leg binding - and not being given the chance of a cure. The Whiteley Clinic can help.
The word “Ulcer” means a break in the layer of cells forming a surface. This can occur in many different areas of the body. In each different area, there are different things causing the ulcer to form.
A stomach ulcer is where the lining of the stomach is broken down in an area so the acid can attack the underlying tissue. The cause, however, is a balance between the amount of acid in the stomach and the factors that protect the stomach lining. You don’t cure a stomach ulcer with creams and bandages!
A leg ulcer is where the skin breaks down allowing air and bacteria to get into the underlying tissue. As we can see the ulcer on the leg, it is tempting to put dressings and creams straight on to it, hoping the skin will grow back. However, years of research have shown the usual cause of leg ulcers is not the skin, but the underlying blood supply to the skin.
Therefore successful treatment of ulcers and successful prevention of ulcers must be directed at correcting the underlying cause, not the ulcer itself.
Although it is obvious who has an ulcer, it can be more difficult for people (as well as non-specialist doctors and nurses) to spot those who are heading towards ulceration.
With improving information, many people with severe varicose veins are seeking specialist opinions and are quite correctly bypassing doctors who give the old advice of “leave them until they cause a problem”.
However, many people most at risk of ulceration do not have any varicose veins to see. These people have SUPERFICIAL VEIN VALVE FAILURE – having inflammation of the skin, but the veins have not dilated and so no varicose vein can be seen.
One of the early warning signs of this is a RED or BROWN PATCH of skin on the lower leg, just above the ankle, usually on the inner side. This is usually called Lipodermatosclerosis (LDS). If this is left without treatment (or if creams or pressure stockings are given instead of referral to a Vascular Surgeon) this slowly deteriorates to dark brown staining – called HAEMOSIDERIN. If this is left longer, white patches appear in the skin, where the skin itself is breaking down. These rapidly go on to complete breakdown and ULCERATION.
At any stage in this deterioration, a referral to a specialist vascular surgeon is likely to result in definitive treatment that not only stops further deterioration but often reverses the whole process.
One note of CAUTION – The patient MUST be able to use the LEG PUMP – therefore if the patient is not able to walk of has poor ankle movement, it is unlikely that surgery will be able to help. There is little point in stopping the reflux after pumping, if there is no pumping in the first place.
So in a nutshell, those who need assessment for treatment are: