What it is
A leg ulcer is an open sore on the leg or ankle that takes longer than expected to heal. Unlike a simple scrape, it often has an underlying cause, which is why professional evaluation matters.
Two of the most commonly discussed types are venous and arterial ulcers. Venous ulcers are linked to veins that have trouble returning blood to the heart, while arterial ulcers are linked to reduced blood flow reaching the leg and foot. Other causes, such as diabetes, pressure, or certain medical conditions, can also play a role.
Because different types of leg ulcers can look similar but behave differently, identifying the cause is typically a key part of leg ulcer wound care. Only a licensed clinician can determine what type of ulcer is present.
How it’s traditionally been approached
Traditionally, leg ulcer wound care has begun with an evaluation of the wound and the person's overall health, including circulation in the legs. Clinicians may look at the wound's size, depth, drainage and surrounding skin.
Common approaches have included cleaning the wound, removing non-healthy tissue (debridement), and using dressings chosen to suit the wound. For venous ulcers, compression has long been a familiar approach, while for arterial ulcers, clinicians generally assess blood flow carefully before deciding what is appropriate.
Other options discussed in wound care settings include negative pressure wound therapy, which is well-established, as well as skin substitutes and amniotic or placental grafts. Skin substitutes and grafts vary in FDA status, since many are regulated as minimally manipulated tissue rather than FDA-approved drugs, and coverage differs by product and payer. Hyperbaric oxygen therapy has FDA-cleared indications in certain situations, such as some diabetic foot ulcers, but it is not appropriate for every wound. For further reading on amniotic products specifically, amnioticdoctors.com is one resource, though it is not affiliated with WoundKare.
How the right wound care specialist may help
The right wound care specialist may help by looking for the underlying reason a leg ulcer is not healing, rather than only treating the surface. A visit generally includes a conversation about your history, a look at the wound and the surrounding skin, and often a check of circulation in the legs.
Specialists may also coordinate with other professionals, such as vascular providers, primary care clinicians or podiatrists, depending on the situation. Whether any particular option is suitable is a decision for a licensed clinician after an evaluation.
Helpful questions to ask a licensed provider include: What is causing my wound? How is it staged or classified? What treatment options exist and what are their pros and cons? What is the expected healing time? What will insurance cover? What signs should prompt me to call you or seek care?
The whole-person view
Body, mind and stress affect each other. A wound that lingers can bring discomfort, limited movement, disrupted sleep and worry, and stress can in turn affect how a person feels day to day. Many people find that looking at the whole picture, including rest, nutrition, movement and emotional well-being, is part of caring for themselves alongside medical care.
Some people explore body-based support such as Somatic Experiences to help them feel more at ease in their bodies during a long recovery. Others find talk therapy through Therapists.plus useful for coping with frustration or anxiety. These are optional supports that complement, and never replace, care from a licensed wound care professional.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly if you notice signs of infection, such as spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or if a wound is rapidly worsening.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound.
- Licensed professionals should guide care for leg ulcers, since the cause determines what is safe and appropriate; what suits one type of ulcer may not suit another.
- If you are in crisis or feeling overwhelmed, call or text the 988 Lifeline. WoundKare is educational and does not give medical advice.
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Frequently asked questions
What is leg ulcer wound care?
Leg ulcer wound care is the professional evaluation and management of open sores on the lower leg that are slow to heal. It typically involves identifying the underlying cause, such as vein or artery problems, and caring for the wound accordingly. A licensed clinician determines what is appropriate for each person.
What causes leg ulcers?
Leg ulcers are most often associated with circulation problems, either in the veins or the arteries. Other factors such as diabetes, pressure, injury or certain medical conditions can also contribute. A provider needs to evaluate the wound to find the cause.
What is the difference between a venous and an arterial leg ulcer?
A venous ulcer is linked to veins having difficulty returning blood from the leg, while an arterial ulcer is linked to reduced blood supply to the leg. They can look different and call for different approaches, which is why a professional evaluation matters. Only a licensed clinician can tell them apart.
When should I see a doctor about a leg ulcer?
It is reasonable to have any leg sore that is not healing, or keeps returning, evaluated by a licensed provider. Seek care promptly for spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills. For heavy bleeding, exposed bone or tendon, or signs of sepsis, call 911 or go to the ER.
How does a wound care specialist treat a leg ulcer?
A specialist commonly starts by assessing the wound, your health history and circulation, and then discusses options suited to your situation. Approaches can include wound cleaning, debridement, dressings, compression for certain ulcers, and other therapies. The specific plan is decided by a licensed clinician after an evaluation.
How long does a leg ulcer take to heal?
Healing time varies widely depending on the cause, the wound's size and depth, overall health and other factors, and no timeline can be promised. Ask your provider about your wound's cause, staging, treatment options, expected healing time and insurance coverage so you know what to expect.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.