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Living with Leg Ulcers?

I was wondering what you would recommend for treatment and prevention of leg ulcers. My grandmother has a real problem, but I have a hard time getting her to do the things I recommend.

Answer (Published 3/28/2005)

The most common kind of leg ulcers are called venous stasis ulcers and usually occur in people who have a medical history of leg swelling, varicose veins, or blood clots in veins in the legs. These account for between 80 to 90 percent of all leg ulcers. They typically develop below the knee, most frequently on the inner part of the ankles and can occur on one or both legs. They often weep fluid and are easily infected.

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Another type of leg ulcers are ischemic or arterial ulcers which usually show up on the heels, tips of the toes, between the toes or wherever protruding bones rub against socks or shoes. These can be very painful, particularly at night. They tend to develop in people who have poor circulation in their legs, usually as a result of smoking, atherosclerosis and diabetes.

Diabetic ulcers tend to develop at pressure points on the bottom of the feet and may occur as a result of trauma from pressure, injury or dry skin. Because of nerve damage that can go along with diabetes, affected people may not feel pain due to trauma (this is the reason why it is essential that diabetics carefully check their feet for injury every day and never go barefoot).

Regardless of what kind of ulcer you have, treatment requires keeping the affected area clean by bathing it gently with warm water and mild soap. This will help loosen and wash away dead skin and any debris from the ulcer. Comfrey root ground into a powder with a blender and mixed to a paste with water or aloe vera gel, then packed in the ulcer can help with healing. Cover the paste with a bandage and change the poultice once a day, washing out the wound with hydrogen peroxide to prevent infection. In addition, venous ulcers should be helped along by compression with a stocking or ace bandage.

Your grandmother should see her physician to find out what kind of leg ulcers she has in order to get appropriate treatment. If the ulcers stem from a circulatory problem in her legs, she may need treatment, possibly surgery, to restore circulation.

Andrew Weil, M.D.

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