Introduction

Standard ulcer care includes:

• wound cleansing and debridement
• diagnosing and minimising oedema (see Oedema and ulcer and wound healing)
• treating infection, if present (see Ulcer and wound infection)
• optimising wound moisture balance (see Ulcer and wound dressings).

Refer patients to a vascular specialist for consideration of revascularisation. Promote cardiovascular risk modification, and monitor progress. Encourage patients to stop smoking, and optimise management of comorbidities (especially diabetes, hypertension, hyperlipidaemia, obesity). Advise patients to care for the surrounding skin (see Skin care) and assess the patient’s diet for nutritional deficiencies (see Nutrition).

Compression is not routinely indicated for patients with an arterial leg ulcer because it may further restrict blood flow. However, it may be used by an appropriately trained healthcare professional for patients with mixed arterial and venous disease, or who have another indication for compression (eg oedema), as long as the patient is monitored regularly. See Compression therapy.