Leg ulcers are common. Approximately 2% of adults will have a leg ulcer at some stage in their lives. Literally thousands of people develop a leg ulcer each year in the United Kingdom and many of those get more leg ulcers as the years go by. Despite the misery they cause, leg ulcers remain a neglected problem.
Causes of leg ulcer.
4 out of 5 ulcers (80%) are caused by a problem with the leg vein pump and they are called venous ulcers. The leg vein pump is the mechanism by which blood flows out of the leg back to the heart. So problem with the deep veins such as obstruction from a deep vein thrombosis, superficial vein reflux or perforator vein problems can cause venous leg ulcers. The leg vein pump depends mainly on good ankle movement, good calf muscles and healthy leg veins. About 95% of venous leg ulcers can be correctly identified by their appearance, by checking by pulses in the feet and by checking sensation.
Where on the leg do you get venous ulcers?
Venous leg ulcers appear on the lower part of the leg usually just above the ankle. Often, the are varicose veins or thread veins around the ulcer and leg is usually swollen. The skin is often thickened and discoloured by varicose eczema which may actually develop many month or years before the ulcer as a warning sign that the vein circulation is not normal.
Leech therapy for complicated varicose veins.
We evaluated the effectiveness of medicinal leech therapy in producing venous decongestion, reversal of oedema, hyperpigmentation and healing of varicose ulcer(s). Whether the leech selectively sucks venous blood was also investigated. Hirudo medicinalis (medicinal leech) was applied to the area surrounding the varicose ulcer(s) in 20 patients with varicose veins with complications and the patients monitored for ulcer healing, and decrease in hyperpigmentation, oedema and limb girth. After leech therapy all the ulcers showed healing, while ninety five per cent of patients (95%) showed a decrease in oedema and limb girth. Seventy five per cent patients (75%) demonstrated a decrease in hyperpigmentation. Thus it appears from this study that the medicinal leech sucks venous blood and aids ulcer healing, and can probably therefore be used as an effective adjunct in the management of complicated varicose veins.