Kids' wounds may heal in no time, but as you age—particularly if you have diabetes or at risk for venous or artery diseases—you're more likely to develop wounds in your legs and feet that are slow to heal and can cause serious health problems.

Fortunately, these wounds (or ulcers) can be treated effectively if caught early. Better yet, they can often be prevented. "When you look at what's presented at wound clinics, all of these are very common and, for diagnosis, a problem," says Teresa L. Carman, MD, Director of Vascular Medicine at University Hospitals Case Medical Center in Cleveland, Ohio. "Venous wounds are probably the most frequently occurring; they're also usually the easiest to heal."

Risk on the rise Perhaps one of the top risk factors for lower extremity wounds is advancing age.

"We're seeing an increasing number and an increasing risk of wounds for our aging population," says Dr. Carman. "As people get older, they're less mobile and they tend to have co-existing medical problems which make them predisposed."

Co-existing conditions behind lower extremity wounds include venous disease, diabetes and peripheral artery disease (PAD). It's possible that some people with those underlying conditions may be undiagnosed. Therefore, high blood pressure, high cholesterol and smoking can also be considered potential risk factors for not only vascular disease but lower extremity wounds as well.

Hot spots
Lower extremity wounds can be treated fairly easily when caught early, so an important part of detection is keeping an eye on the areas where they're likely to crop up. It's important to keep in mind the different types of lower extremity wounds because they influence where on your legs or feet you're likely to find wounds, should they develop.

"Venous wounds are typically over the inside of the ankles; neuropathic wounds are usually over bony prominences in the feet where there's pressure that's not well-managed; and artery wounds can be anywhere, but they predominate over the feet and toes," explains Dr. Carman.

If you have any of the risk factors for lowerextremity wounds, you should check these areas on a regular basis. Diabetics, in particular, need to make foot monitoring a habit.

"Diabetics, because they frequently don't have good sensation in their feet, need to look at their feet every single day to make sure they don't have any areas where the foot is red or feels warm," says Dr. Carman. "They should also be on the lookout for areas where a callous is coming along because that indicates they have pressure issues." They should also inspect their shoes regularly before putting them on.

Because of their neuropathy, small objects (pebbles for example) can cause problems over time for the diabetic patient who may not feel them in their shoes. People with diabetes should also visit their podiatrist every three months for nail care and shoe evaluation, recommends Dr. Carman.

Other types of wounds—especially venous wounds—may show up without any heralding signs, points out Dr. Carman. So while precursor symptoms are unlikely, you should check your legs and feet regularly so that you'll notice any new wounds right away.

Avoiding complications
When wounds are treated early, they usually mend effectively, says Dr. Carman. "When a wound is in the very acute, new stage, the body tends to heal it very quickly—as if it were an injury," she explains. "Wounds that are allowed to persist for more than 4-6 weeks don't want to heal as well. At that point, a wound becomes chronic and there tends to be delay in and resistance to healing."

In addition to becoming chronic, other dangers of unaddressed wounds include infection and—in the worst-case scenario—amputation.

If an infection occurs, you may notice symptoms such as pain, redness and a foul-smelling discharge coming from the wound. Such symptoms mean you need to see your healthcare provider right away. Another indicator that the wound has advanced is a change in color. Any wound that has turned black or yellow (or green) needs to be addressed immediately as well.

"There are a lot of potential problems if wounds are left untreated," says Dr. Carman. "If it's over a bony prominence or on the foot, and the infection gets down into the bone (a condition known as osteomyelitis), then a patient can be at risk for losing a portion of the toe, foot or even the leg. That doesn't happen often, but that's always the potential."

Prevention is possible
Fortunately, it's often possible to prevent wounds from occurring in the first place. To do so, you need to take the proper precautions for your condition. "Most venous patients should sleep with the foot of their bed elevated," says Dr. Carman. "Otherwise, they're at risk for swelling, and that swelling puts them at risk for wounds. Using compression is a must."

Another component of wound prevention is skin care. "Patients need to pay very close attention to their skin," she says. "They need to keep it (skin) well moisturized so that it doesn't crack, dry, fissure or split."

Making sure toenails are properly trimmed by a healthcare professional is an important component of wound prevention for diabetics, as is choosing adequate footwear.

In fact, wearing proper shoes is highly important for people with artery conditions as well.

"Patients with underlying artery disease need to be very careful because even a small amount of trauma from an ill-fitting shoe can actually cause a very serious wound," says Dr. Carman. "So, similarly, they need to be very careful with their feet and protect them."

By following these precautions, it's possible to prevent many lower extremity wounds and the dangers that can follow them. Contact your health care provider to discuss foot and leg care in further detail.