- A Specialist medical referral may be appropriate for:
- treatment of underlying medical problems
- ulcers of non-venous etiology (rheumatoid; diabetic; arterial; mixed etiology)
- suspected malignancy
- diagnostic uncertainty
- reduced ABPI (e.g., <0.8 – routine vascular referral; 0.5 – urgent vascular referral)
- increased ABPI (> 1.2 as in calcification of vessels)
- rapid deterioration of ulcers
- newly diagnosed diabetes mellitus
- signs of contact dermatitis (spreading eczema; increased itch)
- cellulitis
- consideration for venous surgery
- ulcers which have received adequate treatment, and have not improved for three months
- recurring ulceration
- ischemic foot
- infected foot
- pain management
- clients with suspected sensitivity reactions (should be referred to a dermatologist for patch testing). Following patch testing, identified allergens must be avoided and medical advice on treatment should be sought
- a non-healing or atypical leg ulcer which should be considered for biopsy
Clinical Management
Assessment and Management of Venous Leg Ulcers
Point of Care Resources