Leg ulcers and lymphoedema

Leg ulcers are a common and costly problem that can be influenced by a number of medical conditions. It is imperative that the correct diagnosis is made and therefore a thorough medical history plus careful examination of the wound and the surrounding skin is required. At each visit the maximal longitudinal length should be recorded and the wound documented photographically. Factors that may impede healing, such as reduced mobility, must also be considered. For venous ulcers, sustained graduated compression is the mainstay of treatment. Ulcers can be very painful and adequate analgesia should be prescribed particularly during dressing changes when the pain can be magnified. Referral to other medical professionals such as podiatrists is often useful for assistance with gait assessment and provision of appropriate footwear. Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce quality of life. Treatment includes manual lymphatic drainage, compression bandaging and specialist application of kinesio tape.