Why is my leg swollen around the wound?

Swelling can be an early sign of venous insufficiency, a feature of the skin around a venous ulcer, or a sign of infection when it is new or increased. Which it is decides what should be done about it.

Swelling around a leg wound can mean three different things. Knowing which kind you have is the whole of this question, because what you do about it differs.

As a sign of the underlying condition. Leg swelling, heaviness and cramping are early signs of venous insufficiency. That’s blood pooling in the leg veins because the one-way valves have become weak or the veins scarred and blocked.

As a feature of the wound itself. With venous ulcers, the surrounding skin may be shiny, tight, warm, or hot, and discolored.

As a sign of infection. Contact your provider for redness, increased warmth, or swelling around the wound, along with more drainage than before or drainage that is yellowish or cloudy, bleeding, odor, fever or chills, and increased pain.

The word that separates the third from the first two is increased. Swelling that has been there for months and swelling that is new or worse this week are different observations, and only you know which this is.

For swelling of the first kind, there are specific steps. Put your feet above your heart as often as possible, for example lying down with your feet propped up on pillows. Wear compression stockings or bandages every day as instructed — they help prevent blood from pooling, reduce swelling, help with healing, and reduce pain. Take a walk or exercise every day.

One caution on compression. Compression is the treatment for a venous leg wound, but with ischemic ulcers, do not wear compression stockings or wraps unless told to by your provider, because they may restrict blood flow. Swelling on its own does not establish which wound a leg has.

What to watch for

Contact your provider about signs of infection: redness, increased warmth, or swelling around the wound, together with more drainage than before or drainage that is yellowish or cloudy, bleeding, odor, fever or chills, and increased pain.

For swelling from venous insufficiency: elevation above the heart, daily compression as instructed, and daily walking or exercise.

Do not start compression on the strength of swelling alone. With ischemic ulcers, do not wear compression stockings or wraps unless told to by your provider, because they may restrict blood flow.

Swelling that is new, or worse than it was, is the version worth reporting.

Wound Wizard is general education and cannot assess your leg. Your own clinician is the right person to ask.

What we look at

  • Examining the leg and the skin around the wound
  • Checking the blood flow in the leg
  • Deciding whether the swelling is new or longstanding
  • Advising on compression and elevation

Sources

  1. Venous ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000744.htm
  2. Ischemic ulcers - self-care — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000742.htm