Complications of leg ulcer can arise when these chronic wounds fail to heal properly, are mismanaged, or are affected by underlying medical conditions. In many cases, leg ulcers may seem minor at first, but if left untreated or inadequately addressed, they can lead to significant health risks. Understanding the full scope of complications of leg ulcer is crucial for effective prevention, timely intervention, and the preservation of a patient’s long-term health and mobility.
Infection and Delayed Healing
Infection is one of the most common complications. Because ulcers create open wounds, they provide a way for bacteria to enter the body. Minor infections cause redness, swelling, heat, pus, and bad smell. If not treated quickly, the infection can spread deeper, leading to cellulitis or even bone infection (osteomyelitis). People with diabetes or weak immune systems face a higher risk of the infection spreading throughout the body, which may lead to sepsis, a life-threatening condition.
Delayed healing is also a major problem. While small wounds usually heal within weeks, leg ulcers can stay open for months or longer. Poor blood flow, ongoing pressure, and chronic inflammation slow the healing process. This can lead to long-term pain, frequent medical visits, and reduced mobility. In these cases, the complications of leg ulcer affect quality of life and increase medical costs.
Skin Conditions and Tissue Changes
People with poor vein function often develop venous eczema, also called stasis dermatitis. This skin condition results from blood pooling in the lower legs, causing itching, flaking, and skin discoloration. Over time, the skin becomes weak and more prone to new ulcers forming around old ones.
Another possible outcome is lipodermatosclerosis, where fat and skin in the lower leg harden and scar. This makes the skin less flexible and reduces blood flow, increasing the chance of new ulcers and making them harder to heal. The leg may take on a shape known as the “inverted champagne bottle” due to these changes.
Scarring, Pain, and Diabetes Complications
Scarring is another concern. While scars may seem harmless, they are less flexible and more likely to reopen with minor injury. Some patients also develop thick or raised scars, which can cause discomfort or affect appearance.
For people with diabetes, the complications of leg ulcer can be more severe. Poor blood sugar control slows healing and weakens the immune system. In extreme cases, the ulcer may turn into gangrene, which can lead to amputation. Diabetic leg ulcers are a leading cause of non-traumatic limb loss around the world.
Pain, Mental Health, and Financial Burden
Pain is often underestimated but can greatly impact daily life. Chronic pain from ulcers affects sleep, work, and social activities. Some patients may rely on strong pain medicine, which brings risks like constipation, bleeding, or addiction. Pain can also lead to less movement, causing muscles to weaken over time.
The emotional toll is also serious. Patients with long-term ulcers often feel embarrassed or ashamed. Visible dressings or the smell of infected wounds can lead to isolation and depression. As ulcers drag on, mental health problems become more common, requiring support alongside physical treatment.
Cost is another burden. Treating leg ulcers needs regular clinic visits, special dressings, compression socks, and time off work. The total cost of treatment, transport, and supplies can add up. For people with limited access to care, this may stop them from getting help, making the complications worse.
Malignancy, Swelling, and Recurrence
A rare but serious risk is cancer. Some ulcers that don’t heal for over a year may turn into a type of skin cancer called Marjolin’s ulcer. Any long-lasting wound that starts to bleed, rise, or change shape should be checked with a biopsy.
Another issue is lymphoedema, or fluid build-up in the legs. This often happens after repeated infections or tissue damage. The swelling causes more discomfort and makes ulcers more likely. Managing this condition needs special care like drainage, compression, and sometimes surgery.
One of the most frustrating complications of leg ulcer is recurrence. Even after healing, ulcers often come back if the root cause—like vein disease or diabetes—is not managed. Patients may fall into a cycle of healing and re-ulceration. Over time, this cycle can weaken leg function and reduce quality of life.
Joint Stiffness and Prevention Strategies
When movement is limited during healing, joint stiffness or contractures may develop. Ankles or knees can lose flexibility, making it hard to walk or balance. Physical therapy helps prevent this, especially in older or bed-bound patients.
To reduce the complications of leg ulcer, a team-based care plan works best. Early treatment, proper wound care, compression use, and lifestyle changes all play a role. Patients should learn how to spot infections, take care of their skin, wear compression socks, and raise their legs when needed.
In summary, complications of leg ulcer range from mild infections to severe issues like amputation or cancer. These problems affect not just physical health, but also mental, social, and financial well-being. Early action, consistent care, and full-body treatment offer the best chance at healing and avoiding serious risks.
