Treatment Protocol for Venous Leg Ulcers

Protocol for assessment of ulcers has been followed andulcer has been identified as Venous with ABPI greater than 0.8

Before Applying Compression

If leg swelling is present reduce by bed rest and elevation Cardiac failure should be managed.

Applying Compression

Measure ankle and calf circumference Choose appropriate bandaging Apply elastic graduated compression from toe to knee The type of dressing applied underneath the compression has no effect on ulcer healing

Antibiotics should only be used if there is evidence of cellulitis Topical antibacterial agents are frequent sensitisers and should be avoided

Holistic Treatments

Patient should be encouraged to exercise if appropriate Analgesia prescribed as necessary Calorific intake should be increased by 1000 calories per day

Patients with the following features should be referred to the appropriate Specialist

Diabetes Mellitus Peripheral Vascular Disease (ABPI>0.8) Rheumatoid Arthritis/Vasculitis Suspiciaon of Malignancy Atypical distribution of ulcers Contact dermatitis or dermatitis which is resistant to topical steroids

Formal reassessment should be carried out every three months