Venous leg ulcers

Venous leg ulcer treatment

A venous leg ulcer is a wound on the lower leg, usually near the ankle, that is slow to heal because of high pressure in the leg veins. Treating the faulty veins, alongside good wound care and compression, helps an ulcer heal faster and makes it less likely to come back.

Seen within 2 weeks of GP referralWound care, compression and vein treatment in one placeManly and St Leonards

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About venous ulcers

What causes a venous leg ulcer?

When the valves in the leg veins stop working, blood flows backwards and pools in the lower leg. The pressure in the veins rises, fluid leaks into the tissues, and over time the skin around the ankle becomes stained, fragile and slow to heal. A small knock or scratch can then turn into an ulcer.

Most venous ulcers are linked to faulty surface veins, which can be treated. Some are related to a previous deep vein thrombosis (DVT).

Signs of a venous ulcer

An open wound on the lower leg, often above the inner ankle, that has not healed after 2 weeks

Swelling of the ankle, usually worse at the end of the day

Brown staining of the skin around the ankle

Dry, itchy or red skin (venous eczema), or hard, tight skin

Aching or heaviness in the leg

Varicose veins, although not everyone has visible ones

See your GP the same day if the skin around the ulcer becomes hot, red and spreading, you have a fever, or the pain is getting worse, as these can be signs of infection.

Treatment

Why treating the veins matters

Dressings and compression help an ulcer heal, but they do not fix the faulty veins underneath. Research shows that treating the veins early, while the ulcer is still open, helps it heal faster and lowers the chance of it coming back.

Vein ultrasound

A duplex ultrasound shows which veins are faulty and whether the deep veins are affected.

Arterial ultrasound

We check the blood supply to the leg before starting firm compression, as compression is not safe if the arteries are narrowed.

Wound care and compression

Dressings and compression bandaging are done in our rooms, so your wound care and vein treatment are managed together.

Treating the faulty veins

The faulty veins are closed from the inside through a needle, with radiofrequency ablation and foam sclerotherapy, usually while the ulcer is still open.

Keeping it healed

Once healed, compression stockings and follow-up ultrasound help stop the ulcer coming back.

What happens

From referral to healing

GPs and nurses can find referral details on our information for doctors page.

Referral

Ask your GP to refer you, marked "venous ulcer". We see patients with leg ulcers within 2 weeks of referral.

Assessment

Dr McConnell assesses your leg and wound, with a vein ultrasound and an arterial ultrasound to check the blood supply.

Treatment

Wound care and compression start straight away, and the faulty veins are treated as part of your plan.

Follow-up

We see you until the ulcer has healed, and keep your GP updated with letters and ultrasound reports.

Your doctor

Dr Ryan McConnell

BMBS, FRANZCR · Interventional radiologist

Dr McConnell is an interventional radiologist and vein specialist. He looks after your ultrasound, wound care plan and vein treatment himself, so every part of your care is coordinated.

More about Dr McConnell

Questions

Common questions

Are venous ulcers painful?

They often ache, especially when the leg hangs down, and the pain usually eases with raising the leg and compression. An ulcer that is very painful, particularly at night, should be checked for a problem with the arteries.

How long does a venous ulcer take to heal?

It varies from weeks to months, depending on the size of the ulcer, how long it has been there and your general health. Treating the faulty veins helps it heal faster.

Will my ulcer come back?

Venous ulcers can come back if the underlying vein problem is not treated. Treating the faulty veins and wearing compression stockings afterwards lowers that risk.

Do I need a referral?

Yes, please ask your GP to refer you, marked “venous ulcer”, and we will see you within 2 weeks. A referral also means you can claim the Medicare rebate and we can keep your GP updated.

How much does it cost?

The first consultation is $330, with a Medicare rebate of $88.40 with a GP referral. Your vein and arterial ultrasounds are bulk billed with a referral. If you need vein treatment, it costs the same as our other varicose vein treatment, and you get a written quote first. See our fees

Leg ulcer that isn't healing?

Ask your GP for a referral marked “venous ulcer”, then call us and we’ll see you within 2 weeks, in Manly or St Leonards.