What to do when venous leg ulcers fail to heal

worry lady

  • If no improvement in wound healing/ulcer size in 4 weeks, ensure diagnosis of VLU is correct.
  • Take a biopsy if other aetiology or malignancy is suspected or if not healing after 4-6 weeks
  • Is the surrounding skin of reasonable quality – has any varicose eczema been adequately treated?
  • Is the treatment correct? If unsure, refer to specialist particularly if unsure of aetiology on presentation or non-healing atypical leg ulcers. It is important that the HCP is able to recognise when the management of an individual is beyond their competency and they make appropriate referral to a specialist service (eg, specialist VLU service, vascular, dermatology, diabetes service or cardiology).

EWMA Statement 5.4.b: Specialised leg ulcer clinics are recommended as the optimal service for treatment of VLU in the primary care setting

Further Reading:

The Lindsay Leg Club Foundation promotes and supports community based treatment, health promotion and education for people with leg ulcers.