Ulceration of the lower limbs: causes and consequences

By Cristiano Antonino Last updated Sep 17, 2022

The causes of a lower limb ulceration can be many: venous insufficiency, arteriopathies, connective tissue diseases, tumours

Venous insufficiency (varicose veins, previous venous thrombosis) often occurring on the inside of the leg, around the malleolus, are very disabling, often chronic, painful and cause great discomfort for the patient.

The cause is essentially related to venous stasis, which causes the skin to suffer, leading to oedema, continuous microhaemorrhages (ochre dermatitis), eczema, dermohypoderma and finally ulceration, often preceded by a minor trauma on an already very thin skin.

The ulceration tends to become infected and the infection hinders healing

Ulcers can last for months or years.

When they no longer respond to common therapies (dressings, elastic stockings, drugs), certain therapies aimed at treating the cause are necessary:

Surgical therapy of varicose veins;
endoscopic ligation of perforants;
skin plastic surgery.

Varicose vein therapy is often sufficient to heal the ulcer

Other times, endoscopic ligation of the perforants (s.e.p.s.) must be resorted to, and in some cases, to shorten and facilitate healing, skin plastic surgery can be used, by grafting flaps of skin taken from other areas of the patient’s own body.

The risks of surgery are minimal.

The healing rate is close to 100 % in the first two months after surgery and remains high (no recurrence) in the following years (90 % in the first ten years), especially if the various types of surgery are combined.