Review of arterial leg ulcers

Patients can deteriorate rapidly, so frequent review is needed initially (up to daily if compression is used). Regular review (including monitoring for progression of arterial disease and cardiovascular risks) is needed. Frequency of review depends on patient characteristics, and wound characteristics and progression. Risk factor modification includes smoking cessation, diet modification, and exercise.

Educate patients to check their ulcer and advise their healthcare professional of any complications (eg worsening pain or exudate).

If the ulcer is not healing as expected:

• address the factors affecting ulcer and wound healing
• refer to a specialist for management or assessment of arterial or venous disease
• optimise management of comorbidities (eg heart failure, diabetes)
• review the diagnosis (see Differential diagnoses for ulcers or wounds).