The nursing profession in recent years has evolved from simply  using a 'problem-solving' approach to using an 'holistic' approach.

In simpler terms, rather than simply trouble-shooting specifically identified problems with a patients physical condition there is now more of an awareness and  assessment of the patient's whole lifestyle and  the effect that that can have on the successful treatment of a condition or illness. Click on this button for a description of an Holistic assessment which can print and keep

What can I do to help with my healing process ?

Well the two commonest types of leg ulcer are venous (diseases of the veins) and arterial (diseases of the arteries). Here are some important factors listed to care for these types of ulcers.

Venous leg ulcers ?

Diet  A well-balanced diet is essential to give the body the nutrients it needs to promote healing.  Particularly important to the healing process are foods high in protein (meats, nuts, dairy products) and vitamin C (contained in fresh fruit and vegetables). It is also important to control your weight, not only for general good health,but increased weight causes increased pressure in the legs which is detrimental to healing.

Look after your feet.  It is very important that footwear fits properly and is comfortable and supportive without being tight or constrictive. Also good footcare is essential therefore toenails should be cut regularly and dry skin should be massaged if possible with moisturising cream. Skin on the legs and feet can become very sensitive to certain products so make a note of any products that cause stinging or irritation and discontinue use. Inform your district nurse or doctor of this so it can be recorded  on your notes.

Exercise.  If you are able try to walk a reasonable distance each day as walking sti          mulates the venous return and helps to keep swelling down in the legs and ankles, though standing still  for long periods of time can be detrimental by increasing swelling. If you are unable to walk far, keep your legs elevated  on a stool as often as possible whilst sitting and rotate your feet in a circular motion clockwise and anticlockwise to stimulate the circulation. Avoid crossing your legs. At night if possible, elevate the foot of the bed or put cushions under the mattress.

Support hosiery and compression.  During the period of healing the ulcer,  nurses may apply compression bandaging to promote and hopefully quicken the healing process. This is sometimes hard to tolerate  initially as the bandages  can feel tight when first applied. But as swelling in the limb reduces and often the amount of fluid loss through the dressings reduces, it may become more comfortable.Even when the ulcer is healed it is still important to maintain some pressure on the limb to stop the area breaking down again. This is where compression hosiery can be useful. Ask your nurse or doctor for advice about compression/support tights or stockings as it may be necessary for you to be measured for the correct sizing

Smoking. Cut down or preferably give up smoking as it has been proven that smoking can constrict blood vessels and delay healing.

Psychological factors. Mentally,a persons attitude to the way they cope with having a leg ulcer can affect healing both directly and indirectly. It is important to be compliant to treatment even if progress does seem slow. Staying motivated for long periods of time is also very hard; keeping up with exercises that are time-consuming or uncomfortable can be difficult and can lead to a feeling of helplessness and low expectation. BUT! many leg ulcers do heal and some even after very long periods of time. Try to stay positive and reflect on whether there is anything you have overlooked that you could do to improve your quality of life. 

Arterial leg ulcers

Diet , looking after your feet and smoking are the same as above.

Exercise.  If you are able try to walk a reasonable distance each day to stimulate the circulation.If you are unable to walk far, try to lift the feet and rotate the ankles clockwise and anticlockwise to keep the circulation stimulated. Keep the legs warm, as cold temperatures will constrict the vessels futher without exposing them to excessive heat; for example sitting too close to an open fire.

Due to the nature of arterial ulcers, they must never have compression applied. The only exception to this rule is if  tests show the arteries to be only slightly affected with venous problems present, in which case mild compression might be used by an experienced practioner.

At night arterial ulcers are often more painful and many people find relief by hanging their legs out of bed at night. Night sedation or analgaesia taken at bedtime may help to alleviate this problem.

It is only fair to say that many people will suffer with leg ulcers for years as there is no magic cure. Having said that modern dressings can help make life more comfortable and looking at the information above, there may be actions you can decide on using to help care for your ulcer.