Ulcer Treatment

What is a Skin Ulcer?

A skin ulcer is an open sore or wound that develops on the skin. Skin ulcers can be prolonged by poor blood flow. Good blood flow is necessary for wound healing. Poor blood circulation problems can cause minor injuries to not heal properly and turn into a skin ulcer.

Bedsores, also known as pressure sores or pressure ulcers, are skin sores that form when constant pressure or friction damages the skin and the tissue underneath, especially over bony areas.

What Causes Skin Ulcers?

Skin ulcers happen for a variety of reasons, including diabetes, atherosclerosis (arteries become narrow due to fat buildup called plaque), pressure from staying in one position for too long (being restricted to a bed or chair) and venous insufficiency (veins cannot send blood from your legs to your heart). Smoking also causes tissues to not heal and are related to arterial ulcers.

What are the Types of Skin Ulcers?

Venous and Arterial Ulcer

Arterial and venous ulcers typically occur on the lower leg.

• Arterial ulcer: Lack of blood flow to the area of tissue
• Venous ulcer (or venous stasis ulcer or venous insufficiency ulcer): Caused by vein dysfunction causing pooling of blood in the lower legs

Diabetic Ulcers

Foot ulcers are a common complication of diabetes. Having good foot health is key to preventing ulcers.

Causes of diabetic foot ulcers include:

• High blood sugar: Slows the healing process of foot ulcers, so blood sugar management is critical
• Nerve damage: Long-term effect that can lead to a loss of feeling in the feet
• Poor circulation: Blood isn’t flowing to the feet efficiently
• Poor foot hygiene: Not regularly washing, drying or moisturizing your feet

Diabetic foot ulcers are classified on a scale of 0 to 5 using the Wagner Ulcer Classification System.

• 0: No open lesions, intact skin
• 1: Superficial ulcer involving skin
• 2: Deeper ulcer, extending to tendon, capsule or bone
• 3: More extensive ulcer with associated abscess, bone infection or joint infection
• 4: Local gangrene of the toes or forefoot
• 5: Extensive gangrene in entire foot (potentially life-threatening condition where body tissue dies due to a severe lack of blood flow, a serious bacterial infection, or both)

Pressure (Decubitus) Ulcer

Decubitus ulcers, referred to as pressure ulcers or bedsores, are injuries below the skin and tissue caused by prolonged pressure. These ulcers can occur as quickly as 90 minutes under certain circumstances.

Pressure injuries are organized into different categories:

• Stage 1: A bruise like mark appears that’s red, blue or purplish in color. It might feel warm to the touch and possibly burn or itch.
• Stage 2: The bruise turns into an open sore that looks like an abrasion or blister. The skin can be discolored around the wound.
• Stage 3: The sore deepens and now looks like a crater. There are dark patches of skin around the edges of the wound.
• Stage 4: Damage has spread to the muscle, bone or joints. It can cause a serious bone infection called osteomyelitis and lead to a life-threatening blood infection called sepsis.

How to Treat Skin Ulcers

There are several methods used to heal skin ulcers, depending on the level of severity.

Antibiotics: Ointment, oral or IV is used if your ulcer is infected.

Dressing changes: Helps to protect the wound and keep it clean, while promoting healing and preventing infection. Your provider will explain how to dress your wound.

Offloading: Reducing or eliminating the weight and pressure to the ulcer to promote healing

Surgery: If conservative treatments don’t work, surgical treatment can be considered.

Can Ulcers Go Away on Their Own?

Ulcers can take weeks to months to heal. More serious and involved ulcers take years to fully heal. Recovery is impacted by a variety of health risk factors.
If you have a wound that won’t heal, see a healthcare professional immediately, so the ulcer doesn’t get infected.