Review of venous leg ulcers

If compression therapy is initiated, review patients within 24 to 48 hours to ensure they can tolerate therapy (see Compression therapy).

Ideally, review patients with a leg ulcer weekly. If healing is not progressing as expected, despite best practice management (including appropriate endovascular intervention):

• consider the factors affecting ulcer and wound healing
• optimise management of comorbidities (eg heart failure, diabetes)
• review the diagnosis (see Differential diagnoses for ulcers or wounds)
• refer back to the vascular specialist.

Risk factors for delayed healing of venous leg ulcers include:

• patients with mixed venous and arterial disease
• ulcer bigger than 5 cm²
• ulceration for longer than 6 months
• presence of popliteal reflux
• decreased limb mobility
• history of venous ligation or stripping
• history of hip or knee replacement
• fibrin over more than 50% of the wound
• unusual limb shape
• poor skin condition.