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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Large Ulcer On Lower Back Of Leg?

my husband has a large ulcer on the lower back of his leg. They told him after two years of treating it that the only thing they could do was remove part of the Achilles tendon and sew it up. He won t do this. I have been putting promogran prisima on it and wrapping it every other day. To day when I did it the gauze was green when it is normally brown with some blood. There is no smell
Mon, 20 Apr 2015
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Diabetologist,  's  Response
Hello. Read your query and noted the contents.

A large non healing ulcer in the back of the leg (2 yrs) is a cause for concern. If the wound has devitalised tissue it needs to be derbrided either surgically or using enzymatic debriding agents like papain-urea. The greenish guaze suggests that the wound is infected with pseudomonas. You need to dress the wound with silver containing dressing materials along with 5% acetic acid solution. Once the wound is clean you can consider doing a skin graft. To answer to your question abt the need for removing a part of the tendo achilles..though he maybe left with a minor need for change in the footwear he uses to compensate for the abnormal biomechanics secondary to surgery it will not compromise his function in anyway. You should consider that if the doctor advises you so.

Please feel free to drop in any more queries if need be.
Warm regards,
Dr Praveen
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What Causes Large Ulcer On Lower Back Of Leg?

Hello. Read your query and noted the contents. A large non healing ulcer in the back of the leg (2 yrs) is a cause for concern. If the wound has devitalised tissue it needs to be derbrided either surgically or using enzymatic debriding agents like papain-urea. The greenish guaze suggests that the wound is infected with pseudomonas. You need to dress the wound with silver containing dressing materials along with 5% acetic acid solution. Once the wound is clean you can consider doing a skin graft. To answer to your question abt the need for removing a part of the tendo achilles..though he maybe left with a minor need for change in the footwear he uses to compensate for the abnormal biomechanics secondary to surgery it will not compromise his function in anyway. You should consider that if the doctor advises you so. Please feel free to drop in any more queries if need be. Warm regards, Dr Praveen