Ulcus Cruris: Causes, Symptoms & Treatment
Ulcus cruris is a chronic non-healing wound on the lower leg, most commonly caused by venous or arterial circulatory disorders. It primarily affects older adults and requires targeted medical care.
Things worth knowing about "Ulcus cruris"
Ulcus cruris is a chronic non-healing wound on the lower leg, most commonly caused by venous or arterial circulatory disorders. It primarily affects older adults and requires targeted medical care.
What is Ulcus Cruris?
Ulcus cruris (also known as a leg ulcer or open leg wound) is a chronic, poorly healing wound located on the lower leg or ankle. It represents a deep tissue defect of the skin and subcutaneous tissue, typically caused by impaired circulation, lymphatic drainage disorders, or other underlying systemic diseases. Leg ulcers are among the most common chronic wounds worldwide and disproportionately affect the elderly population.
Causes
Ulcus cruris is classified into several types based on its underlying cause:
- Venous leg ulcer (Ulcus cruris venosum): The most common form, accounting for approximately 60–80% of all cases. It results from chronic venous insufficiency (CVI), where impaired venous return from the leg leads to elevated venous pressure, tissue changes, and ulceration.
- Arterial leg ulcer (Ulcus cruris arteriosum): Caused by peripheral arterial disease (PAD), in which narrowed arteries reduce oxygen supply to the tissue. This form is typically more painful.
- Mixed-type ulcer (Ulcus cruris mixtum): A combination of venous and arterial insufficiency.
- Other causes: Diabetes mellitus (diabetic ulcer), vasculitis, infections, tumors, or lymphedema.
Symptoms
Symptoms may vary depending on the type of ulcer but commonly include:
- Open, non-healing wound on the lower leg or ankle
- Irregular wound edges with a fibrinous or necrotic wound bed
- Pain (particularly pronounced in arterial ulcers; venous ulcers are often less painful)
- Swelling of the lower leg
- Skin discoloration and hardening of the surrounding tissue (lipodermatosclerosis)
- Itching and weeping wound exudate
- Unpleasant odor in cases of infection
Diagnosis
Diagnosis is established through a thorough clinical assessment combined with targeted diagnostic procedures:
- Medical history and physical examination: Assessment of wound characteristics, surrounding skin, and circulatory status.
- Doppler ultrasound: Measurement of the ankle-brachial index (ABI) to evaluate arterial blood flow.
- Duplex sonography: Imaging of veins and arteries to identify the underlying cause.
- Wound swab: To detect bacterial colonization or infection and identify pathogens.
- Biopsy: To rule out malignant transformation in atypical or non-healing wounds.
- Laboratory tests: Blood glucose, inflammatory markers, and coagulation parameters.
Treatment
Treatment of ulcus cruris is cause-oriented and follows a multi-modal approach:
Treatment of the Underlying Condition
Addressing the root cause is essential -- whether this involves managing chronic venous insufficiency, peripheral arterial disease, or diabetes mellitus.
Local Wound Care
- Wound cleansing and debridement (removal of necrotic or non-viable tissue)
- Moist wound healing using modern wound dressings (e.g., hydrocolloids, alginates, foam dressings)
- Antibiotic therapy in confirmed wound infections
Compression Therapy
For venous leg ulcers, compression therapy using compression bandages or stockings is the cornerstone of treatment. It reduces venous pressure and significantly promotes wound healing.
Additional Therapeutic Options
- Vascular surgery or interventional procedures for arterial involvement
- Skin grafting for large or treatment-resistant ulcers
- Physiotherapy and exercise to activate the muscle pump
- Adequate pain management
Prognosis and Prevention
Without consistent treatment, ulcus cruris can persist for months to years and lead to serious complications such as deep tissue infections or sepsis. With appropriate therapy, most wounds will heal, but the recurrence rate remains high. Preventive measures include regular physical activity, consistent use of compression stockings, careful skin care, and optimal management of underlying conditions such as diabetes or hypertension.
References
- Deutsche Gesellschaft für Wundheilung und Wundbehandlung e.V. (DGfW): S3-Leitlinie Lokaltherapie chronischer Wunden, 2023.
- Dissemond J. et al. - Ulcus cruris: Diagnosis and Treatment. Dtsch Arztebl Int, 2018.
- European Wound Management Association (EWMA): Venous Leg Ulcers - Evidence and Clinical Practice, EWMA Document, 2022.
Building Blocks for a Healthy Life
As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.
Verwandte Produkte
For Healthy Oral Flora & Dental Care
Formulated lozenges with Dentalac®, lactic acid bacteria, and Lactoferrin CLN®
For your universal protection
As one of the most valuable proteins in the body, lactoferrin is a natural component of the immune system.
For your iron balance
Specially formulated for your iron balance with plant-based curry leaf iron, Lactoferrin CLN®, and natural Vitamin C from rose hips.