What to do and when to be concerned

With June being Wound Healing Awareness Month, it is the perfect time to be mindful and proactive in dealing with what may seem like a minor wound issue before it becomes unnecessarily problematic.

Lower Extremity Edema

When taking your socks off at the end of the day, do you notice “sock lines” or swelling in your feet or legs? If you take a road trip, do you notice your shoes feel tight at the end of your journey? Many people experience swelling, or edema, in their legs for different reasons. Some reasons such as infection, inflammation, blood clots or an underlying worsening medical condition require immediate medical attention. Other times, edema can be due to damaged veins or lymphatic vessels and lead to chronic swelling that may worsen over time.

Leg Ulcers

An ulcer is an open wound or break in the skin on the legs. The majority of open wounds heal without issue within a few weeks. However, it can become chronic when a wound fails to heal due to an underlying problem or poor management. This places a person more at risk for infection.

Venous Leg Ulcers

The most common etiology for an open wound or leg ulcer is due to venous disease from damaged veins or lymphatic vessels and prolonged leg edema. Venous leg ulcers are thought to affect 1% of Americans. Venous leg ulcers are more common in older people and those with a history of varicose veins, a history of smoking, are obese or had a previous blood clot in their legs. Most occur around the ankle and shin area. You may also notice a brown discoloration on your skin.

What You Can Do?

Regular checkups. Your primary care provider can monitor edema in your legs, rule out any underlying causes and refer you to a specialist if needed.

Elevate your legs. Most people notice their swelling is much better in the morning after laying down all night because gravity helps move the fluid out of your legs. Avoid sleeping in a chair where your legs hang down. Elevating your legs above the level of your heart can also help. Talk to your health-care provider if you get short of breath lying down, as it may be a sign of congestive heart failure.

Get moving. Walking is an excellent way to help pump the fluid out of your legs. When you walk, your calf muscle contracts and helps push excess edema out of your legs.

Wear your compression socks. Yes, they are hard to get on. Yes, it is hot, and we live in Louisiana, but if you have venous disease, wearing compression socks is very important to minimize edema in the legs and keep your venous disease from worsening.

Monitor for signs of infection. Any open wound can be a portal for bacteria and infection. If you have an open wound on your leg, monitor for signs of infection such as redness, additional swelling, fever, pain or pus.

Wound Care

If you have an open wound on your leg that has not healed, contact your health provider. They may refer you to a vascular surgeon or wound specialist.

They will assess your legs and can provide a comprehensive treatment plan that may include topical dressings, debridement or removing unhealthy tissue, and compression to alleviate some of the swelling.

LSU Health Shreveport’s Rehabilitation Clinic provides comprehensive wound management in an outpatient setting for people with venous leg ulcers and other wound etiologies. They also run the country’s first and only post-graduate Wound Management Residency within the School of Allied Health Professionals. Several topical treatments, multi-layer compression wraps and modalities such as ultrasound, electrical stimulation and ultraviolet light therapy are utilized at LSU Health to treat and heal wounds.

To learn more about the services offered at the Rehabilitation Clinic at LSU Health Shreveport School of Allied Health Professions, please call 318-813-2970 or visit https://www.lsuhs.edu/our-schools/school-of-allied-health-professions/ rehabilitation-clinic/rehabilitation-clinic.

Sarah Murnane, PT, DPT, is a clinical assistant professor of physical therapy and certified wound specialist at LSU Health Shreveport.