An ulcus cruris, or leg ulcer, is an open sore on the lower leg that does not heal for weeks, often just above the inner ankle. If a wound has not healed after eight weeks, it is considered chronic. The underlying cause is usually chronic venous insufficiency, often after years of varicose veins or after a thrombosis.
When the vein valves fail, the pressure in the veins of the lower leg rises permanently. Fluid leaks into the tissue and the skin is less well supplied: it turns brownish, hardens and becomes thin. Even a small knock can then cause a wound that no longer closes on its own.
Less often, narrowed arteries are the cause, for example in peripheral arterial disease, which is linked to smoking and diabetes. Mixed forms also occur. Because compression can do harm if the arterial blood supply is poor, every treatment starts with the question of the cause.
Weeping wounds, pain, odour and frequent dressing changes weigh on everyday life, sometimes for years, and many people affected withdraw from others. Treatment that tackles the wound and its cause together can promote healing and restore some quality of life.