Venous ulcer will not heal

Dear Ask The Doctor: I have had an ulcer on the inside of my ankle for over 3 years now and is extremely painful. I have been under the hospital and different doctors who keep on trying different treatments including compression dressing, which made the problem worse. It measures about 5cm x 4cm and it smells really horrible. Recently the colour has changed to a dark green with a jet black outline.It's about an eighth inch deep. When I am active it gets worse(bigger). At present the wound is rinsed out and packed with 'Aquacell', square dressings on that then bandaged and stockinet.But it's not helping it to heal.

Dear Michael: I understand your concerns. You should note that venous ulcers are often quite tedious treat and may take a very long time to heal. From the picture you have provided, it seems you have an infected ulcer. You will need more than just frequent dressings to get it to heal. You may need to have the infected/dead tissue surgically removed as well as a course of oral antibiotics. After the infected tissue has been removed and healthy tissue begins to grow a skin graft can placed over the ulcer to aid the healing process. Of course, all this will have to be discussed with you doctor/surgeon. Measures will also have to be taken to treat the underlying problem which is chronic venous insufficiency. These measures may include, compression stockings, injection sclerotherapy or surgery among others.