Arterial Leg Ulcers Tissue Viability 01270 275315 Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 1
Problems that can occur Skin problems When you have an arterial leg ulcer, the surrounding skin becomes very sensitive. This can cause soreness and irritation of the skin. The sensitivity can be due to the leakage of fluid from the ulcer or a possible reaction to creams or dressings. What can I do? Do Not Scratch! See your nurse or doctor, they can identify the cause of the problem and give you the appropriate treatment. Odour Leg ulcers can give off an offensive smell. The odour can be due to many reasons, including the leakage of fluid and sometimes the dressing which has been applied to the ulcer. Seek advice from your nurse if this is a problem. My leg ulcer is painful Unfortunately, having a leg ulcer can be very painful. This may be as a result of exposed nerve endings. Tell your doctor/nurse if you are suffering from pain there are lots of ways to relieve it and they will be able to advise you and prescribe what is best for you. Taking painkillers regularly may help, but always follow the dosage instructions. How can I help to heal my leg ulcer? Wear sensible footwear. Visit a chiropodist regularly, so that he can take good care of your feet and nails. Exercise those legs regularly, to get the calf muscle pump working short walks are better than no walks! Perform foot and ankle exercises regularly. Elevate your legs when you are resting. Keep all appointments with your nurse and doctor. If you have any problems or anxieties telephone your nurse or doctor. Do try to lose weight if you are overweight, as extra weight gives more work for those poor veins. Eat a healthy diet, which should contain plenty of fresh fruit, vegetables, fish and meat. If you wish for more advice, ask to be referred to a dietician. Stop smoking. Avoid standing in one position for any length of time. Shift the weight from one foot to the other. What Causes Arterial Leg Ulcers? Normal arteries in the legs - the arteries supply oxygen and nutrients to the legs. Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 2
What can go wrong? The blood supply becomes reduced when fatty deposits build up on the inside of these arteries. The main reasons why this happens are: Smoking Diabetes High cholesterol High blood pressure Since I ve had a leg ulcer and been taking painkillers, I have been suffering from constipation! Constipation may be a side effect of some of the pain killers you are taking. Your nurse can give you something to help with this. What should I do if I knock my leg or notice a break in the skin? Don t despair or try to treat it yourself contact your nurse immediately. Can the same happen to my other leg? In theory, yes. That is why it is important to regularly examine your legs and advise your doctor or nurse of any changes in: colour, temperature, any breaks in the skin below the knee or any pain. Arterial Exercises The benefits in walking are: Reduces the risk of needing an operation Reduces pain Increases blood flow to the legs This also benefits your general health: Helps to reduce your blood pressure Helps to maintain a healthy weight/lose weight Improves a sense of well-being! Walking To be done 5-7 days per week Start with 5-10 minutes. Increase gradually to 30 minutes at a time. This will generally take up to 12 weeks to reach. You may take short breaks while walking, but try and keep to the recommended time. To feel the benefit, ideally need to walk through the pain in your muscles to a point when it is quite intense. Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 3
Look at the table below: you should aim to walk to level 3 on the scale. Claudication Pain Scale Grade 1 Grade 2 Grade 3 Grade 4 Definite discomfort or pain, but only at an initial or modest level. Moderate discomfort or pain from which you can be distracted. Intense pain from which you cannot be distracted. Unbearable pain: you should not continue to walk if you are experiencing this level of pain. Stop rest and resume when you are able. When you reach level 3 STOP & REST. Allow pain to completely subside the rest time is not counted towards your overall time. After walking Cool down by walking gently round your house or by sitting down and gently tapping your toes and circling your ankles. Keep a record of your walk in your diary. When NOT to walk! If you have a bad cold, flu, high temperature, or are generally unwell or tired. Any injury to muscle or joints Acute episode of arthritic pain in ankles knees or hips. New or increased episodes of chest pain, dizziness, palpitations or breathlessness. Ankle Circles Aims to improve circulation and reduce stiffness. Sit comfortably at the back of your chair. Take one foot an inch off the floor and circle your ankle joint clockwise and then anti-clockwise 3 times. Try and keep your hip and knee joint still and imagine you are drawing a perfect circle with your big toe. Ankle/Calf Stretch Rest on the bed or sofa with legs supported. Big toes in line with your knees. Slowly, on a count of 4, bring your feet towards you. Then, slowly, on a count of 4, move your feet away from you. Do 10 repetitions, 4 times a day. Exercises designed to specifically improve the circulation to your legs. Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 4
Check posture and stand tall. Stand with your feet parallel, slightly narrower than hip-width apart. Slowly come up onto your toes, keeping your weight over the ball of your foot and big toe. Slowly return to start position. Continue for 2-3 minutes. Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 5
For further information on the references and sources used for this leaflet, please contact 01625 661184. Comments, compliments or complaints We welcome any suggestions you have about the quality of our care and our services. Contact us: Freephone: 0800 1613997 Phone: 01625 661449 Textphone: 01625 663723 Customer Care, Reception, Macclesfield District General Hospital, Victoria Road, SK10 3BL For large print, audio, Braille version or translation, contact Communications and Engagement on 0800 195 4194. East Cheshire NHS Trust operates a smoke-free policy (including e-cigarettes) For advice on stopping smoking please contact our Stop Smoking Service on 0800 085 8818. East Cheshire NHS Trust does not tolerate any form of discrimination, harassment, bullying or abuse and is committed to ensuring that patients, staff and the public are treated fairly, with dignity and respect. We welcome user reviews of our leaflets. Please share your comments, reviews and feedback with us by sending to ecn-tr.patientinformation@nhs.net Leaflet Ref: 15031 Published: 12/15 Review: 12/18 Page 6