Nutrition

Adequate nutrition is important to promote wound healing. The majority of patients with venous leg ulcers are overweight or obese; however, these patients are still at risk of malnutrition.

Ask patients about their diet and assess for deficiencies; dietary intakes of omega-3 fatty acids, vitamin C and zinc may be low.

Encourage patients to eat a wholefood, balanced diet, including fish at least twice a week, at least five serves of vegetables a day, and healthy fats (eg avocado, extra virgin olive oil, a handful of nuts). Patients may require referral to a dietitian for comprehensive nutritional assessment.

If a micronutrient deficiency is identified, it should be corrected. Vitamin D, flavonoids and folic acid supplements have been associated with beneficial effects on ulcer healing.

Encourage weight loss for patients who are overweight or obese to facilitate mobility (see Exercise) and reduce venous hypertension.