Tissue viability service
Skin changes of the lower leg
Your skin naturally changes as you get older. Your skin may lose its softness, elasticity, and smoothness over time. However, you may notice more unusual changes such as your legs becoming itchy, dry, flaky and see a discoloured staining. They might feel heavy.
This may be a result of a change in blood flow, increased pressure, or oedema in the lower leg, and should be reported to your medical or nursing team.
What is a venous leg ulcer?
This is the most common type of skin ulcer.
The ulcer can be spontaneous or start as a “leaky leg” blister or injury. Increased pressure in the veins of the lower leg causes fluid to leak and pool beneath the skin. This causes swelling, skin changes and thickening and can mean an ulcer can become large and difficult to heal.
Increased risk of venous ulceration include:
- Blood clots
- Pregnancy
- Lack of exercise
- Being overweight
How compression therapy works
Compression therapy is the term given to hosiery and bandages which are designed to improve blood flow in your leg veins, encouraging the flow of fluids up your limb.
Compression hosiery and bandaging is made of supportive elastic material, fitting snug at the ankle and become less so as they go up the leg.
As the compression therapy helps return flow up the leg this can reduce oedema and pressure therefore:
Reduce the likelihood of developing a leg ulcer
Reduce swelling and aching in the leg
Reduce irritation and discolouration of the skin
Benefits of compression therapy
Compression bandaging or hosiery gently squeeze the leg muscles. This helps to push the blood back to the heart, reducing any swelling in the legs and feet and prevent blood clots from forming.
Wearing them can stop your legs feeling tired and heavy, reduce the bulging of varicose veins and help heal any sores on your leg.
They can also help prevent re-occurrence of any leg ulceration once healed.
What types of compression are available?
- Compression bandages
- Wraps – Velcro type
- Open toe and closed toe hosiery
Modern compression hosiery uses lightweight, comfortable yarns, virtually impossible to tell apart from regular hosiery.
What should I do if I’m advised to have compression therapy?
If you are advised to wear compression bandaging, it is important they are applied by someone with training to do so, and that the bandaging is not tampered with as this could change its effect.
If you are advised to wear compression hosiery, it is important that you wear it – ideally, every day. Your healthcare professional will be able to advise you regarding wearing your hosiery overnight.
Things you can do to help
Do
regularly cleanse and moisturise your legs
walk and exercise regularly … even when relaxing in your chair!
eat a balanced diet and watch your weight
elevate your legs
check your legs and feet regularly
get treatment early for any sores or wounds on your lower leg or feet, especially if you have diabetes
act on advice from your healthcare professional
Don’t
do not cross your legs for long periods of time
do not stand or sit still for long
do not have very hot baths
do not ignore any sores or irritations
do not assume that your leg will just get better by itself
do not smoke
do not remain inactive for extended periods, for example, long journey’s
Simply walking can help flow in your limb, and there are exercises you can do even when your sat or laid down.
Useful leg exercises to help improve your circulation
(flexing the foot)
(rotating the ankle)
(moving up and down)
Compression therapy precautions
As hosiery or bandaging is a medical device your nurse or doctor will complete assessments and chat with you to ensure you have the correct bandages or hosiery.
Compression should always be prescribed by a healthcare professional to make sure it’s safe for you to wear.
But some basic precautions; please remove hosiery or bandages if:
- Your toes become discoloured (white, blue, purple or mottled)
- You suddenly experience pins and needles or loss of sensation in the affected limb or foot.
- If it becomes too tight or painful
- If your affected limb becomes swollen
- If your affected limb becomes red or inflamed
- If you experience chest pains or shortness of breath when wearing, please remove immediately.
Patients who have bandages: please ensure you have access to bandage scissors to enable removal.
If you have experienced any of the above symptoms and have removed your hosiery, do not attempt to reapply. Please get in touch with the team looking after you.
Advice from your healthcare professional
Contact us
If you require further information, please contact the Tissue Viability Team on:
Telephone: 01642 854103
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]