Have you noticed how many people have permanently bandaged legs as they get older?  I asked a nurse why. 

She told me that the way the condition starts can vary, as can the way the result presents on the leg but the underlying cause is almost always to do with the circulation.

Simply put; our arteries take the blood from the heart to all parts of the body while the veins are responsible for taking the used blood (which has collected all sorts of impurities on its journey) back to the heart to be reprocessed. The blood vessels which are further away from the heart are small but they have valves in them, and these valves make sure that the blood flows in the right direction.  As we get older the valves get weaker and impure blood often gets stuck in these smaller blood vessels.  Gravity doesn’t help and is why the problem happens in the lower legs rather than arms.  If the impure blood cannot get back to the heart it will find any break in the skin to escape from and the resulting sore will get bigger as more of this blood needs to escape.

Patients are often offered compression-bandaging to the leg which will support the blood vessels and force the blood to work its way up the body and back to the heart. This is effective as an ongoing solution with the result that support hosiery is always likely to be needed once the ulcer has healed.  But there are some other alternatives.

We contacted the Leg Ulcer Charity whose continued research shows that, as long as the sufferer is able to walk and regardless of age, in up to 60% of cases, surgery can be the answer for a much more permanent cure.

The Leg Ulcer Charity’s Prof. Mark Whiteley told us that the cost of the operation that cures many sufferers has been proved to amount to less than it costs for a year’s worth of visits from a district nurse to dress such a wound and the bandages can often be dispensed with.

I asked the nurse if there was any way that one can find out if they are likely to become affected in the future and if they can prevent this before it starts.  The nurse told me that although it is accepted that varicose veins are usually visible just under the skin, this is a myth.  Many varicose veins are often deep under the skin and so there is no real way of being sure.

We Googled NICE (0300 323 0141)  who are described on line as having been ‘originally set up in 1999 as the National Institute for Clinical Excellence, a special health authority, to reduce variation in the availability and quality of NHS treatments and care’, and their guidelines, [CG168] published in July 2013 state that anyone who has had a ‘venous leg ulcer (a break in the skin below the knee that has not healed within 2 weeks)’ should be referred to a vascular service immediately.  The guidelines also suggest that the use of a duplex ultrasound will help with the development of an accurate treatment plan.

If you have access to the internet or a helpful IT savvy friend you can access the Leg Ulcer charity and their leaflet which makes for very interesting reading.