Leg ulcers in the elderly

[Apintofbest]

DMum has had leg ulcers on and off for about 3 years. She's desperately in need of a knee replacement, but of course the surgeon will not touch her while she has open ulceration on her leg. She has the leg dressed weekly by community nurses, and was ordered to spend most of her time in bed about a month ago to keep the leg elevated and improve circulation. She has been checked for diabetes and does not have it.

The dressing the nurse team have been using is 'silver', and seemed to improve situation slightly, but this week the wounds have got worse - not particularly deep, but bigger.

DMum is quite chipper and very pragmatic, as many elderly people are, but is getting a bit fed up and also a bit sad because DDad is sitting in the living room, she's in the bedroom and they get a bit lonely!

Are there ANY other measures that could be taken with regard to clearing up the ulcers?

I saw a documentary on TV a couple of years ago about treating leg ulcers with sugar. Might be worth investigating?

www.bbc.co.uk/news/uk-scotland-30782619

She could still sit in the living room with your dad but make sure she elevates her legs well.
Has she had doppler assessment by the community nurses and in compression bandaging? If not this should be done.
If doppler results show her circulation is compromised she should be referred to vascular clinic at hospital .
Chronic ulcers do go through periods of becoming critically colonised (infected ) and thats why dressings change from time to time.

Has she had a Doppler assessment or a review by a vascular surgeon? If so, is she suitable for compression bandaging? If it is a venous leg ulcer, compression therapy would normally heal it quite quickly. If there is arterial involvement (so less blood flow to the area), it's likely compression would not be suitable and the ulcer will take much longer to heal.

It all depends on what your mum has had done so far - she may well have seen every speciality she should and her legs just aren't healing. (If she hasn't seen specialist clinic then she definitely should be).

Unfortunately some leg ulcers just don't heal no matter what you do and wounds just have to be managed.

I'd also be looking at nutrition - does she eat properly? Blood tests looking at iron levels, and things like zinc may identify deficiencies which are making wound healing difficult.

Thanks for all your replies. she has had Doppler in the past, but not for a while, and wound has been swabbed before - the nurse who attended yesterday seemed to rule out infection. She also had it checked to rule out something more sinister - DFIL died of lymphoma which first presented as leg ulcer which wouldn't heal so I was a bit concerned. The nurse is supposed to be bringing GP with her next time so will ask about vascular referral. Her diet is perhaps a bit crap - not much in the way of fruit and veg and lots of biscuits/chocolate . Will check into iron and zinc deficiency.