The management of venous ulcers of the legs

The first step in the management of venous leg ulcers is correct diagnosis of the ulcer as venous in type. Calf pump dysfunction and resultant increased venous pressure are significant factors in the pathogenesis of venous leg ulcers. Good management is aimed at correcting these. Exercise, elevation and compression are the most effective means of achieving this and form the mainstay of treatment. The use of topical preparations entails a high risk of sensitization and irritancy. If these develop, healing may be slowed by further damage to the ulcer tissue. Reducing the number of preparations used and avoiding the injudicious use of topical antibiotics minimises this risk. Frequent assessment of the ulcer is also essential. Once healed, prevention of recurrence is an integral part of correct management of venous leg ulcers.