Managing venous leg ulcers

Dealing with the impact of venous leg ulcers (VLUs; Box 1) is challenging for both patients and health professionals. The typical clinical picture of long-term cyclical healing and recurrence has a profound negative physical and psychosocial impact on patients, is a significant burden on limited NHS funds, and places demands on community nurses’ time.

VLUs are the result of chronic venous insufficiency (CVI) in the legs. Blood flow from the legs to the heart is propelled by the pumping action of the calf muscle during flexion of the ankle (during walking, for example). Valves in the veins prevent backflow, but failure of the valves results in increased pressure in the veins. Causes of valve failure include hereditary predisposition, reduced mobility or long periods of standing, ageing, or damage (following venous thrombosis, for example).