Key Learning Points
- All patients with ulcers must have a vascular cause considered
- All patients with ulcers should have their pulses examined
- All patients should have an ABPI
- Mixed aetiology ulcers (arterial and venous) should have the arterial component corrected where possible to aid healing and allow safe compression
- Further vascular imaging may be required (Arterial duplex / MRA / CTA / DSA)
- Revascularisation should be considered in arterial ulcers but may not always be feasible
- Venous ulcers should be managed in compression bandaging
- In diabetic patients with a neuropathic ulcer adequate blood supply must be ensured and appropriate footwear supplied
