BMJ  2004;328:1358-1362 (5 June), doi:10.1136/bmj.328.7452.1358

Clinical review

Management of venous leg ulcers

¹ Academic Department of Surgery, Wythenshawe Hospital, Manchester M23 9LT

The first 150 words of the full text of this article appear below.

Introduction

Leg ulcers are a big problem for both patients and health service resources.^1-3 Most ulcers are associated with venous disease, but other causes or contributing factors include immobility, obesity, trauma, arterial disease, vasculitis, diabetes, and neoplasia (box 1). In the United Kingdom, venous leg ulceration alone has been estimated to cost the NHS £400m ($720m; 600m) a year.^1-3 Much of this cost is accounted for by community nursing services; district nurses spend up to half of their time caring for patients with ulcers.^{1 4}

Most venous leg ulcers could be healed if patients were admitted to hospital for continuous leg elevation. Shortage of hospital beds, the high cost of inpatient care, and the need to maintain independence in this elderly population of patients mean that this once popular approach is now rarely practical.² Furthermore, ulcers often recur when the patient returns home and resumes a lifestyle in which most of the . . . [Full text of this article]

Sources and search criteria

Causes of venous ulceration

Diagnosis and investigation

Management of the ulcer

Future research

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