Welcome to the Leg Ulcer Services Department. Here you will find information about the services offered and useful resources.
Who are we?
The leg ulcer service is run by the district nursing team and supported by the tissue viability team.
Nurses who care for patients with leg ulcers have been provided with training in leg ulcer care and management.
What do we do?
- Assess the cause of the leg ulcer
- Plan care for patients with new leg ulcers
- Undertake doppler assessments of new, chronic or healed leg ulcers.
- On-going care and management of venous leg ulcers.
- Holistic care of all patients with leg ulcers
Referring to the Service:
- Your GP or practice nurse can you refer you to this service if you have a suspected leg ulcer.
- Self referral can be made through the adult community nursing administration team
What will happen to your referral
Once your referral has been received, it will be assessed by an experienced member of the district nursing team.
An appointment will be allocated to you as soon as one is available and you will be seen in the leg ulcer clinic. You may be seen at home but only if you are housebound.
At your first appointment the nurse caring for you will undertake a detailed assessment including a Doppler assessment to assess the blood flow in your legs.
A plan of care will be prepared in conjunction with you and your carers. Patients with arterial ulcers which require specialist intervention will be referred back to their primary care provider for on-going referral to specialist services.
Most ulcers are caused by venous insufficiency and will be managed in the community leg ulcer service. The most common treatment is compression bandaging.
Arterial leg ulcers
What is an arterial leg ulcer?
An arterial leg ulcer is an open sore in the skin of the lower leg caused by the arteries not working correctly. Arterial disease accounts for about 15% of leg ulcers.
What causes an arterial leg ulcer?
Arteries carry blood from your heart to your legs in order to keep them healthy.
Ulcers can develop when the arteries are not working properly and they become blocked or narrowed (arteriosclerosis). This leads to poor blood supply reaching your skin which can make it susceptible to break down.
Who will look after me?
If you are seen and assessed in the leg ulcer service and it is felt that your ulcer is caused by arterial disease, you will be referred back to your GP to organise referral to a specialist Vascular Surgeon.
Caring for your legs
Caring for your legs is an important aspect of healing your ulcer and keeping your legs well after it has healed.
Why is it important to care for your legs?
Leg problems become more common as you get older.
They can be avoided by undertaking good care of your legs, exercising regularly and using supportive equipment or devices as advised.
Leg problems include:
Venous insufficiency - Approximately 50% of people will have some form of this and may suffer from varicose veins, spider veins or leg ulcers.
Arterial disease - accounts for 10 - 15% of leg ulcers. Arteries are blood vessels that carry blood from your heart to your legs in ortder to keep them healthy. Ulcers can develop when the arteries are not working properly and they become blocked or narrowed (arteriosclerosis). This leads to poor blood supply reaching your skin which which can make it susceptible to break down.
Lymphoedema - causes swelling in the body tissues. It is caused when the lymphatic system, a network of vessels and glands throughout the body which help fight infection and drain fluid, is not working correctly.
Venous leg ulcers
What is a venous leg ulcer?
A venous leg ulcer is an open sore in the skin of the lower leg due to high pressure of the blood in the leg veins.
When you have a leg ulcer the most important part of treatment is compression bandaging which must be applied correctly and maintained well.
You must try to keep as active as possible but must also elevate your legs when resting.
Other treatments may be advised in some cases, such as a skin graft or vein surgery. After an ulcer has healed you should wear a support stocking each day which helps to prevent it recurring.
Who will look after me and where will I have to go?
Venous leg ulcers will be cared for by the district nursing team with the support of the tissue viability service where required. Standard clinics are run by the district nursing team and are held at the following centres:
You may be required to attend clinics for dressings 1-3 times per week. Your nurse will advise on the most appropriate level of treatment for you.
It is essential that you follow the treatment guidance of your nurse or doctor to ensure your ulcer heals.
Once healed you will be referred for on-going follow up with the Tissue Viability team. You will need to continue a plan of care even after your ulcer is healed to prevent it from coming back.