Deep wound with cliff edges. Localised oedema with no staining of the surrounding skin. Shiny, hairless skin.

• Refer to a Vascular specialist if required
• Formulate a treatment plan following holistic assessment of the patient and their ulcer within the recommendation of the SIGN guidelines

• Treat the ulcer depending on the condition of the wound bed and surrounding skin
• Do not apply compression
• If ABPI is below 0.8, refer to a Vascular specialist

• Systemic antibiotics should only be used when there is evidence of wound infection ie cellulitis
• Topical antibiotics should not be used.

• Prevent trauma to legs.
• Stop smoking