Chronic ulceration of the leg

The management of patients with chronic leg ulceration represents a significant burden to vascular surgical services in the UK. The majority of leg ulcers are due to chronic venous hypertension, although arterial compromise, malignancy and vasculitis are also recognized causes. The assessment of patients with chronic leg ulceration should include a detailed history and clinical examination, supported by relevant investigations. The mainstay of treatment for patients with chronic venous ulceration is multilayer compression bandaging, applied by trained staff working within a specialist service. Patients with arterial compromise may require endovascular or surgical revascularization to promote healing.In this review article, the causes, assessment and treatment of patients with chronic leg ulceration are discussed.