Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Health Education Fact Sheet

Taking Care of Your Legs

Venous leg ulcers, or venous stasis ulcers, are wounds that may occur on the lower legs in those people who have poor circulation. This may be the result of “valves” in the veins that are not working properly (allowing blood to “pool” in the lower leg).

Here are some more facts:
Venous leg ulcers can occur in both men and women; and may develop as a result of any injury to the leg or conditions such as varicose vein, blood clot in the leg, multiple pregnancies, overweight and standing for long periods of time (e.g., job related situations). They can take a long time to heal and are costly to treat. Venous leg ulcers can also cause you to not be able to move and get around. In addition, they may cause you pain, fear, anger, and depression.

Signs and symptoms may include:
Swollen legs; change in skin colour to a brownish/red; burning or itching sensation; rash, redness or dry, crusty skin. An ulcer is often wet or weeping, and may have a yellow-white film covering it. Venous leg ulcers are usually located just above the ankle.

Caring for your leg ulcer:
Caring for your leg ulcer includes good general health, a healthy diet, careful cleaning and dressing of the wound and use of special leg bandages, called compression bandages. The bandages must be applied by a trained nurse or physician.

You may need help from different healthcare providers as well as help at home. A physician or specially trained nurse will ensure proper assessment, which includes a physical examination, health history and a simple test called a Doppler ultrasound to measure the blood flow to your legs.

If there is good blood flow to your legs, there are treatment options available to help heal your leg ulcer. Some of the treatment options are removal of the damaged tissue, appropriate dressings and wearing compression bandages or compression stockings. Compression works by helping the muscles to squeeze and push the blood back up through the veins and reduce swelling in the lower leg.

What can you do to prevent venous leg ulcers?
There are lots of things that you can do to help prevent venous leg ulcers. Here are some suggestions:
Exercise regularly: Walking is the best exercise to assist the calf muscle to push the blood back towards the heart. If you are unable to walk, do ankle exercise when at rest. This can be done by moving the ankle and foot in a circular motion to the right and then to the left. If you are standing for prolonged periods of time, shift your weight from foot to foot, or stand up on tiptoes and then lower back down again. Do this a few times.
Position: You must raise your legs as much as possible at all times. If you are in bed or lying on a couch, raise your feet so that they are higher than the level of your heart. Support your legs and feet with pillows. Do not cross your legs.
Diet: Eat a healthy balanced diet and maintain an appropriate weight for your height. Being overweight will put an extra strain on your veins.
Smoking: Cut down or even better, stop smoking as it may interfere with healing. (See the RNAO health education fact sheet on smoking cessation available at www.rnao.org/bestpractices)
Shoes: Wear comfortable low-heeled shoes to accommodate stockings or bandages.
Dressings: Do not interfere with the dressings as you may damage or infect the leg ulcer. If you experience any discomfort from the dressings or bandages, contact your nurse or other healthcare professional.

What should you do when the ulcer is healed?
Once the ulcer is healed: check your skin and moisturize daily; continue to wear support stockings or bandages as prescribed (refer to the manufacturer’s instructions for use or ask your nurse to demonstrate their use); replace your stockings every 3 to 6 months to maintain a proper level of compression; take care not to injure your legs; do not sit close to fire – avoid extreme temperatures; continue an exercise program, healthy diet and leg elevation as before. If you see any damage to your skin, contact your nurse or doctor for advice.