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Wound Care and Leg Ulcer Management
Wound Care and Leg Ulcer Management provides specialist assessment and evidence-based compression and dressing therapy for chronic leg ulcers -- accurately diagnosing the ulcer type, implementing the most effective healing strategy, and preventing recurrence.
Overview
Chronic leg ulcers affect 1 in 100 adults over 65 causing profound disability and social isolation. Accurate diagnosis of the ulcer type is essential -- venous ulcers require high-compression four-layer bandaging, arterial ulcers require vascular surgery before compression, and diabetic foot ulcers need multidisciplinary assessment. Evidence-based wound dressing selection based on wound bed preparation optimises the wound environment for healing.
Types of Chronic Leg Ulcers
- Venous Leg Ulcer (80% of leg ulcers -- medial gaiter area with lipodermatosclerosis)
- Arterial Ulcer (deep, painful, punched-out, distal, absent pulses)
- Mixed Arteriovenous Ulcer (venous and arterial disease coexisting)
- Diabetic Neuropathic Foot Ulcer (plantar surface with callus)
- Diabetic Ischaemic Foot Ulcer (combined ischaemia and neuropathy)
- Pressure Ulcer (bony prominences -- sacrum, heel, trochanter)
- Vasculitic Ulcer (punched-out, painful from systemic vasculitis)
- Pyoderma Gangrenosum (rapidly spreading with undermined edge)
Wound Bed Preparation Principles
- Debridement (removal of necrotic and fibrinous tissue)
- Moisture Balance (optimal wound moisture without maceration)
- Edge Advancement (stimulating epithelial migration across the wound)
- Infection Control (distinguishing colonisation from clinical infection)
- Compression Therapy (mandatory for venous ulcers with adequate arterial supply)
- Nutrition Optimisation (protein, zinc, vitamin C for wound healing)
- Underlying Disease Management (diabetes control, vascular referral)
- Patient Education (compression compliance, footwear, self-monitoring)
Indications for Specialist Leg Ulcer Assessment
- Chronic leg ulcer failing to reduce by 50% after 4 weeks of optimal therapy
- Ulcer of uncertain aetiology requiring diagnosis before treatment
- Suspected arterial ulcer requiring ABPI before compression
- Diabetic foot ulcer requiring multidisciplinary foot team assessment
- Recurrent venous ulceration requiring compression and venous duplex
- Leg ulcer with features of malignancy
- Atypical morphology suggesting vasculitis or pyoderma gangrenosum
- Infected ulcer with spreading cellulitis or systemic infection
Key Benefits
Discover the advantages of choosing our wound care and leg ulcer management services.
Evidence-based compression therapy heals 70 to 80% of venous ulcers within 12 to 24 weeks
Systematic wound bed preparation creates the optimal healing environment
Correct wound dressing selection reduces healing time and patient pain
Underlying venous disease treatment halves the recurrence rate
Lifelong compression stockings after healing reduce recurrence from 70% to below 30% over 5 years
Clinical Features
The technology, techniques and clinical approach behind our wound care and leg ulcer management.
ABPI measurement mandatory before any compression therapy is applied
TIME wound bed preparation framework guides systematic debridement
Dressing selection evidence-based on wound bed characteristics
Four-layer high-compression bandaging at 40 mmHg is the gold standard for venous ulcer treatment
Post-healing class 2 compression stockings prescribed lifelong to prevent venous ulcer recurrence
Preparation Instructions
Wear prescribed compression stockings every day from morning to bedtime -- this is the most important single intervention for venous ulcer healing and prevention of recurrence. Elevate your legs above heart level for at least 4 hours daily. Attend all wound review appointments. Contact the wound care team immediately for sudden increase in pain, spreading redness, fever, or significant increase in wound discharge.
The Procedure
Step-by-step guide to what you can expect during your wound care and leg ulcer management procedure.
Ulcer Assessment and ABPI Measurement
Wound dimensions are measured photographed and wound bed characteristics are assessed. Ankle Brachial Pressure Index measurement using hand-held Doppler confirms arterial supply before any compression is applied -- ABPI below 0.8 contraindicates full compression.
Wound Bed Preparation
Wound bed preparation follows the TIME principles (Tissue debridement Infection management Moisture balance wound Edge advancement). Debridement removes necrotic tissue creating a clean granulating bed.
Dressing Selection
Wound dressing is selected based on wound bed characteristics -- hydrogel for dry necrotic wounds alginate or foam for moderate to high exudate antimicrobial silver dressings for critical colonisation.
Compression Therapy Application
For confirmed venous ulcers with ABPI above 0.8 four-layer high-compression bandaging providing 40 mmHg at the ankle is applied. Compression is the single most important treatment for venous ulcers.
Infection Assessment and Management
Wound swabs are taken for culture when infection is clinically suspected. Systemic antibiotics are prescribed for clinical wound infection -- topical antibiotics are not recommended due to resistance and sensitisation risk.
Underlying Condition Management and Recurrence Prevention
Venous disease is assessed with duplex ultrasound for venous reflux correction. After healing class 2 compression stockings are prescribed lifelong for venous ulcer recurrence prevention.
What to Expect
Your specialist measures wound dimensions, assesses wound bed characteristics, and performs ABPI to confirm arterial supply before compression is applied. A wound dressing protocol and compression regimen appropriate for your specific ulcer type is prescribed with clear application instructions.
Frequently Asked Questions
Common questions about wound care and leg ulcer management.
Related Services
Explore other services in our Dermatology department.
Psoriasis Management
Eczema and Atopic Dermatitis
Skin Lesion Assessment and Biopsy
Ready to Get Started?
Schedule your consultation today and take the first step towards better health.
