A leg ulcer is an area of non-healing skin that can occur anywhere on the lower leg or toes.

Lower leg ulcers occur when there is a loss of the superficial layers of the skin. These ulcers can occur anywhere on the lower leg. They may present as a chronic non-healing wound on the leg or at the tips of the toes. The cause of these lower leg ulcers can be quite variable. Patients with risk factors for peripheral vascular disease are especially at risk for developing these ulcers. Risk factors for peripheral vascular disease include smoking, diabetes mellitus, high blood pressure, and high cholesterol. Individuals may develop a lower leg ulcer after trauma to the skin. These ulcers may also develop without any precipitating event.

Normal skin has several layers that provide protection to infection and injury. When the superficial layers of the skin break down, the resulting open wound is called an ulcer. Ulcers are problematic for several reasons. Since leg ulcers represent an area of skin breakdown, the natural barrier to infection becomes compromised which may result in infections. Also, a leg ulcer may represent an underlying disorder in the circulation to the leg. These circulatory conditions if left untreated, may progress to gangrene and result in limb loss. Ulcers should therefore be evaluated and treated to prevent chronic wounds, infections, and possibly limb loss.

Since one of the causes for leg ulcers may be from a blockage in the arteries, it is important for patients to seek evaluation and possibly treatment. Fortunately, these blockages usually represent a correctable problem. A vascular surgeon can evaluate these ulcers and determine if there is a problem with the blood supply to the lower leg. When an arterial blockage does appear to be the cause of these ulcers, we can frequently correct the arterial blockage using minimally invasive techniques. Using special balloons and stents, these blockages can often be treated without surgery in an outpatient setting. Some patients whose arterial blockages are not amenable to balloons or stents may require surgery. The surgery will involve doing a bypass around the area of blockage in order to provide more blood to the ulcer and the surrounding normal skin. This normal skin will then be able to regenerate the deficient layers of skin over the ulcer. Healing the ulcer will restore the skins natural barrier to infection and help prevent limb loss.