Leg Wounds

A wound that refuses to heal is more than a physical inconvenience. It is a signal that something deeper is going on in your body, and it deserves more than basic first aid. Chronic leg wounds can be painful, discouraging, and disruptive to daily life, but they are not something you simply have to endure.

At Miller Vein, we specialize in identifying and treating the root causes of chronic leg wounds, not just the wounds themselves. By addressing the underlying conditions that prevent healing, whether that is poor circulation, venous insufficiency, or another contributing factor, we help patients achieve faster recovery, reduced discomfort, and lasting protection against future complications.

Modern care has come a long way — see leg wound treatment options for what treatment involves.

Our board-certified specialists serve patients at clinics throughout Michigan, including Auburn Hills, Dearborn, Grand Rapids, Holland, Macomb, Novi, St. Clair Shores, and Troy.

Curious to learn more? Read a simple guide to wound healing on our blog.

Venous Leg Ulcers

Venous ulcers are the most common type of chronic leg wound, making up the majority of all leg ulcers seen in our practice. They develop as a consequence of venous insufficiency, a condition in which the one-way valves inside the leg veins fail to function properly. When those valves weaken or fail, blood flows backward and pools in the lower legs rather than returning efficiently to the heart.

Your provider may also recommend complete decongestive therapy where appropriate.

Over time, this pooling creates elevated pressure within the veins and surrounding tissue. Fluid, red blood cells, and inflammatory proteins leak out into the tissue. The skin is deprived of adequate oxygen and nutrients, becomes fragile and inflamed, and eventually breaks down. The result is an open sore, most commonly located on the inner ankle or lower leg, that the body struggles to close because the pressure driving it has not been resolved.

Venous ulcers tend to have shallow, irregular borders with surrounding skin that is often discolored, thickened, or weeping. They produce moderate to significant wound fluid and are typically accompanied by leg swelling and aching.

Arterial Ulcers

Arterial ulcers have the opposite underlying cause. Rather than blood pooling due to poor venous outflow, arterial ulcers develop when blood cannot reach the tissue adequately due to narrowed or blocked arteries, a condition called peripheral arterial disease (PAD). Without sufficient blood supply, the tissue is starved of oxygen and begins to break down.

Arterial ulcers tend to appear on the toes, the outer ankle, or the tops of the feet. They typically have well-defined, punched-out borders and a pale, grey, or necrotic wound bed. The surrounding skin is often cool, hairless, and shiny. Pain from arterial ulcers is often significant and characteristically worsens when the leg is elevated, since gravity can no longer assist blood flow to the foot.

Diabetic Foot Ulcers

Diabetes creates a particularly challenging environment for wound healing. Diabetic peripheral neuropathy reduces sensation in the feet, meaning that small injuries, friction points, or pressure from ill-fitting shoes may go completely unnoticed until significant damage has already occurred. At the same time, impaired immune function and reduced tissue perfusion associated with diabetes slow the healing process substantially.

Diabetic foot ulcers most commonly develop at pressure points on the sole of the foot. Because neuropathy can eliminate pain in the affected area, they are often not noticed until they are well established. This makes regular foot inspection a critical habit for anyone with diabetes.

Pressure Injuries

Pressure injuries, sometimes called pressure sores or decubitus ulcers, form when sustained pressure on a specific area of the body restricts blood flow to the skin and underlying tissue. They are most common in people with limited mobility and typically develop over bony prominences such as the heel, ankle, or lower leg. The compromised tissue breaks down progressively if the pressure is not relieved.

Patient Stories to
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The front desk personnel were very professional and welcoming. I was seen by one of the most welcoming and patient ultrasound technicians. She was very pleasant and informative. She explained every step and made me feel comfortable throughout the exam. The doctor is the reason the office is so calm and welcoming. The doctor was informative as she explained the diagnosis and plan of care needed. I would definitely refer someone in need of their services.

— Brenda F.

I was not sure if I would like it here, and that was only because of my past experience with another clinic. This place here was very nice. They took their time with me. Made me feel very comfortable. Especially when the Doctor gave me the treatment plan, I was so happy with it. Thank you everyone at Miller Vein clinic you’re the best.

— Lora W.

Great Clinic! So glad I went. My legs feel so much better! I can already see some of the benefits and will just get better over time! The doctors and staff are so kind and friendly. Such an easy location with lots of free parking. Highly recommend!!

— Vicky M.

My experience was amazing. I got there a little bit early, I was taken right back. Everybody was very nice, explained everything to me as they went. I would recommend Miller Vein to anybody; they are fantastic.

— Stacie N.

Why Chronic Leg Wounds Do Not Heal on Their Own

When a wound is chronic, it means the healing process has stalled. The body has not lost the ability to heal, but something is actively getting in the way. Understanding what that something is makes all the difference.

• For venous ulcers, the obstacle is elevated venous pressure. The tissue surrounding the wound is saturated with fluid that is low in oxygen and rich in inflammatory proteins. Every time the wound begins to close, the same hostile tissue environment breaks it down again. No dressing, no topical treatment, and no amount of time will permanently close a venous ulcer while that pressure remains unaddressed.
• For arterial ulcers, the obstacle is inadequate blood supply. The tissue cannot receive the oxygen and nutrients delivered by the bloodstream that it needs for cellular repair and immune defense. Without restoring circulation, healing cannot occur.
• For diabetic wounds, the obstacles are often multiple and simultaneous: impaired nerve function, reduced immune response, compromised circulation, and elevated blood glucose that interferes with cellular repair mechanisms.

This is why at Miller Vein, our approach goes beyond wound dressings and surface care. We evaluate and address the underlying circulatory cause so that the wound has the conditions it needs to actually heal.

Risk Factors for Chronic Leg Wounds

Chronic leg wounds do not develop randomly. Several well-established conditions and lifestyle factors increase a person’s risk significantly. Knowing your risk profile is one of the most useful things you can do to protect yourself from developing a wound or catching one early before it becomes a serious problem.

Chronic Venous Insufficiency (CVI)

CVI is the single most important risk factor for venous leg ulcers. When the valves in the leg veins fail and blood pools in the lower legs, the sustained tissue pressure gradually damages the skin from within. The longer vein disease goes untreated, the more vulnerable the lower leg becomes to breakdown.

Diabetes

Diabetes contributes to chronic wound risk through multiple mechanisms at once. Peripheral neuropathy removes the warning signal of pain, meaning minor injuries or pressure points go unnoticed until significant damage has already occurred. Reduced immune function impairs the body’s ability to fight infection. Poor peripheral circulation limits tissue perfusion, and elevated blood glucose interferes directly with cellular repair processes.

History of Deep Vein Thrombosis (DVT)

A prior DVT can permanently damage the valves of the deep venous system as the clot resolves, leaving behind chronic venous hypertension that persists long after the original clot is gone. This complication is a driver of venous leg ulcers in patients who may not connect a wound they have today to a clot they experienced years earlier.

Obesity

Excess body weight increases the pressure placed on the veins of the pelvis and lower legs, worsens venous insufficiency, and impairs the lymphatic drainage that helps clear excess fluid from the tissue. Obesity also reduces mobility, which diminishes the calf muscle pump that plays a critical role in returning blood from the legs to the heart.

Immobility and Reduced Activity

The calf muscle pump is one of the body’s most important defenses against venous pooling. People who are largely sedentary, bedridden, or have limited ankle mobility lose the benefit of this pump, allowing venous pressure to build progressively over time.

Prior Leg Ulceration

A history of previous leg ulcers is one of the strongest predictors of future ulceration. Healed ulcer sites are typically covered by scar tissue that is less durable and resilient than intact skin, making those areas significantly more susceptible to breakdown.

Smoking

Smoking impairs peripheral circulation, reduces the amount of oxygen available to the tissue, slows cellular repair, and increases vascular inflammation. It both accelerates the progression of underlying vascular disease and makes wounds that have already formed harder and slower to heal.

Age

As the body ages, vein walls and valves lose elasticity, skin becomes thinner and more fragile, and the healing response slows. The cumulative effects of decades of venous pressure, hormonal changes, and physical wear make chronic leg wounds increasingly common from middle age onward.

Recognizing the Warning Signs

Chronic leg wounds rarely appear without prior warning. For venous ulcers in particular, there is typically a recognizable progression of skin and tissue changes that precedes wound formation. Catching these early signs provides an important opportunity to intervene before an ulcer develops.

Early Skin Changes to Watch For

• Brownish or reddish staining around the inner ankle and lower leg, caused by iron deposits from red blood cells that have leaked into the tissue from pressurized veins
• Skin that feels increasingly firm, tight, or woody, particularly on the inner lower leg, indicating the fibrotic changes of lipodermatosclerosis
• Persistent swelling that does not fully resolve after a night of rest with the legs elevated
• Dry, flaky, or itchy skin on the lower leg, which can signal venous dermatitis caused by chronic venous inflammation
• Areas of skin that look thin, fragile, or unusually pale against a backdrop of discoloration

Signs a Wound Is Forming or Has Formed

• Any area of skin that has broken open, even if it appears small or superficial
• A shallow sore on the inner ankle or lower leg that does not show improvement within two weeks of basic wound care
• A wound that weeps clear or yellowish fluid
• Tissue immediately surrounding the wound that is increasingly warm, red, or tender

Urgent Symptoms That Require Prompt Care

• Rapidly spreading redness, warmth, and swelling around the wound, which may indicate cellulitis
• A wound that develops an unpleasant odor or produces discolored discharge
• Fever or chills accompanied by a worsening wound
• A wound that suddenly increases significantly in size

Do not wait on any of these urgent signs. Infection in a chronic wound can escalate quickly and may require immediate medical attention.

The Role of Vein Treatment in Wound Healing

For patients with venous leg ulcers, treating the underlying vein disease is not optional. It is the most important intervention available.

Clinical evidence consistently shows that patients who receive endovenous treatment for the reflux driving their ulcer heal faster and experience significantly lower rates of recurrence than those who receive wound care alone. The venous hypertension that created the ulcer does not resolve by itself, and wound dressings, however carefully applied, cannot counteract the tissue-level environment that sustained pressure creates.

When venous reflux is corrected, the pressure in the surrounding tissue drops, oxygen and nutrient delivery to the skin improves, inflammatory activity decreases, and the wound gains the biological conditions it needs to close and stay closed. For many patients, venous treatment is the turning point after months or years of slow or absent progress with wound care alone.

At Miller Vein, addressing the vascular root cause is the foundation of everything we do for patients with chronic leg wounds. Our board-certified physicians perform minimally invasive, in-office procedures with no surgical incisions and minimal recovery time, making treatment accessible even for patients who have been managing a wound for an extended period.

Preventing Chronic Leg Wounds

The majority of venous leg ulcers are preventable. The key is recognizing and treating the conditions that lead to them before tissue breakdown occurs.

Treat Vein Disease Early

Endovenous treatment of chronic venous insufficiency reduces venous hypertension at its source and significantly lowers the risk of ulcer development. Patients who address vein disease before skin changes appear or progress have a much lower lifetime risk of ulceration than those who manage symptoms conservatively until a wound forms.

Wear Compression Consistently

For patients with known CVI, daily use of graduated compression stockings is the single most effective preventive measure available. Compression reduces tissue pressure throughout the day, slows disease progression, and has a well-documented protective effect against ulcer formation and recurrence.

Protect Lower Leg Skin

Regular moisturizing with appropriate products maintains skin integrity and reduces fragility.

Stay Active

Regular walking activates the calf muscle pump, which plays a critical role in venous return. Even short, frequent walks throughout the day meaningfully reduce the venous pooling that drives tissue damage over time.

Monitor and Manage Contributing Conditions

Controlling blood glucose in diabetes, following up on any history of DVT, managing body weight, and quitting smoking all reduce the cumulative vascular risk that leads to chronic wounds.

Regular Check Ups

If you have CVI, a history of prior ulceration, or significant risk factors, make visual inspection of your lower legs and ankles a regular habit.

Leg Wound Care Across Michigan

Miller Vein provides expert evaluation and treatment for chronic leg wounds at eight convenient locations throughout Michigan. We see patients at:

• Auburn Hills
• Dearborn
• Grand Rapids
• Holland
• Macomb
• Novi
• St. Clair Shores
• Troy

Our Chronic Leg Wound
Treatment Options

Effective management of chronic leg wounds requires treating the wound surface and the underlying cause simultaneously. Our approach integrates expert vascular care with comprehensive wound management protocols to give patients the best possible path to healing.

Endovenous Ablation Sclerotherapy Compression Therapy Wound Care Protocols

Endovenous Ablation Sclerotherapy Compression Therapy Wound Care Protocols

For venous ulcers driven by reflux in the great or small saphenous vein, endovenous thermal ablation is the cornerstone treatment. A thin catheter is inserted into the affected vein under the guidance of ultrasound and delivers controlled heat energy that seals the vein shut. Blood reroutes naturally through healthy surrounding vessels, venous pressure in the lower leg drops, and the tissue environment improves significantly in the weeks following treatment.

The procedure is performed in the office under local anesthesia, takes approximately one hour, and requires no surgical incisions. Most patients resume light activity the same day.

Learn More

Sclerotherapy is used to treat smaller contributing varicose and reticular veins that are adding to venous hypertension in the wound area. Ultrasound-guided sclerotherapy allows treatment of veins beneath the skin’s surface that cannot be seen but are measurably contributing to pressure in the affected tissue.

Graduated compression is the most evidence-supported conservative intervention for venous leg wounds. Applied correctly, compression counteracts elevated venous pressure in the tissue, reduces edema, improves lymphatic drainage, and significantly accelerates wound healing. Multi-layer compression bandaging is often used during the active healing phase, transitioning to compression garments for long-term maintenance once the wound closes.

Appropriate wound dressing selection protects the wound bed, manages moisture, reduces infection risk, and supports the body’s natural repair process. The right dressing depends on the wound’s depth, the volume and character of fluid it produces, and whether infection or non-viable tissue is present. Our team provides individualized wound care guidance and ensures dressing management is coordinated with vascular treatment throughout the healing process.

Frequently Asked Questions About Leg Wounds

Board-Certified Specialists That Practice with Care

Our dedicated Team

Dr. Rana Burek, DO

Jeffrey H. Miller, MD

Jennifer Malicke, DO

Krista M. Bannon, MD

Madeline Paquette, DNP

Michael E. Lulenski, MD

Robin Doak, CLT

Steven K. Wang, MD