Chronic Leg Ulcers
A leg ulcer is an open wound or sore on the skin of the leg, usually below the knee. It is considered a chronic or non-healing wound if it does not show signs of healing after three months of treatment or is not completely healed after 12 months. In severe cases, the ulcer never heals.
There are different types of chronic leg ulcers. The most common, which occur in almost 80% of all patients with chronic leg ulcers, are venous ulcers, which are caused when the valves in the veins in your legs don’t work correctly. Damage to these valves allows blood that should flow upward to your heart to leak backward. This in turn raises the blood pressure in your veins, which can cause several problems, including chronic leg ulcers.
Many factors can raise your risk of venous ulcers, including:
- Family history of venous disease
- Limited physical activity
- Knee surgery or knee replacement
- Varicose and spider veins
Other factors can cause chronic leg ulcers or prevent their healing, such as various medical conditions and diseases. Between 2% and 10% of all people with diabetes mellitus suffer from foot ulcers. Pressure ulcers can also occur in patients who are in generally reduced health and are unable to move about on their own.
When you are starting to develop an ulcer on your leg, you might see that your skin is getting dry, cracked, or scaly. You might also notice that your skin is red or otherwise discolored. If the ulcer gets worse, the growing wound can become wider, longer, and deeper. In advanced stages the ulcer might go down to the bone. You might see a ring around the center of the wound that feels harder than the skin around it. With an infection, you might also notice:
- Swelling in your leg
- Wound warmth
- Drainage in your sock
- A strong smelling wound
MicroGenDX Tests Used in Diagnosing Chronic Leg Ulcer Infections
An evaluation and culture (growing microbes from your sample in a lab) are often used to diagnose leg ulcer infections. However, standard cultures might come back negative even when you actually do have an infection, and that means your infection won’t be treated. A MicroGenDX test detects the DNA of all microbes in your sample along with how much of each microbe is present and uses that information to identify causes of your infection and the drugs that can best treat it.
You can order a MicroGenDX WoundKEY test and get complete instructions here: https://microgendx.com/product/woundkey-test-service-dm-intl/
Providing Samples for the Chronic Leg Ulcer Infection Test
Your doctor will use one of two methods to provide a sample for this test: the swab method or debridement, which is the surgical removal of dead or contaminated tissue. Both methods start by using gauze and saline to lightly wipe the surface area to remove dead skin and tissue.
For the swab method, your doctor will roll the swab over entire surface area of the wound, applying pressure as it moves across the wound. As much material as possible needs to be gathered on the swab to ensure a conclusive sample. Then the swab will be inserted into the specimen tube, which will be sealed tightly.
For the debridement method, your doctor might use a numbing agent such as injectable Lidocaine for your comfort. Then your doctor will collect the sample by scraping the entire surface of the wound. There might be a little bit of bleeding. If possible, your doctor will collect samples from all areas of the wound to ensure a full and accurate sample, and then transfer the sample into a 2mL specimen vial.
Everything you need to know about how chronic leg ulcer samples are taken is included with the WoundKEY test and is also available online on the product page. The instructions included with your test contain illustrations that will help you to help your doctor collect a sample without contaminating it. It is always important to obtain a proper sample by following the instructions for collecting the sample, as well as when packaging and shipping it. For example, with either method, be sure not to contaminate the sample by touching it with your hands. For best results, you must be off all antibiotics for two days before the sample is collected. However, if this is not possible, the test can still be run.
Medical Specialties That Treat Chronic Leg Ulcer Infections
A permanent effective treatment always targets the cause, which usually requires a team approach. Treatment plans are customized to each patient’s needs and are developed by experts in wound care, vascular medicine and vascular surgery, podiatry, diabetes or endocrinology, infectious disease, dermatology, and orthopedics.
How Chronic Leg Ulcer Infections are Treated
Venous ulcers don’t heal on their own. The longer you live with them, the greater the chance you can have permanent tissue damage. The first step is to find the underlying cause of the problem. Treatment is not simple, and one type of treatment does not fit all patients.
Successful treatment of chronic leg ulcers is only possible if they are diagnosed correctly. If an infection is present, it can be treated by antibiotics that may be taken orally, applied topically on the surface of the wound, or both. How long and how often you take an oral antibiotic or apply a topical antibiotic depends on what your doctor prescribes. Carefully following the instructions for using the antibiotics your doctor prescribes is very important. Additionally, all MicroGenDX diagnostic tests include detection of antibiotic resistance genes in your sample, and then provide alternative antibiotics for your doctor to consider prescribing to you.
Using compression therapy is important when treating most patients with chronic leg ulcers. Your therapy options also might include surgery.