CLASSIFICATION OF ULCERS

Defined as having the following characteristics:

Defined as having any of the following characteristics:

Defined as having both venous and arterial components that may include the following characteristics:

• ABPI 0.8–1.3
• Area <100cm2
• Present for less than 6 months

• ABPI outside of 0.8–1.3 range
• Area ≥100cm2
• Present for more than 6 months
• Controlled/uncontrolled cardiac failure
• Current infection and/or history of recurrent infections
• History of non-concordance with treatment
• Wound has failed to reduce in size by 20–30% at 4–6 weeks despite best practice
• Fixed ankle or reduced range of motion
• Foot deformity
• Unmanaged pain

• ABPI <0.8 or >1.3 (NB: if ABPI <0.5, no compression should be applied and urgent referral for consideration for revascularisation should be made)
• Symptoms of arterial disease – such as intermittent claudication (muscle pain that is experienced upon exercise and relieved when rested) – even if ABPI is within the normal range

A simple VLU should be managed in a primary care or community-based environment by clinicians who are competent in administering compression therapy (Harding et al., 2015).

A complex VLU should be managed by a specialist service that deals with VLUs.

May still require compression and should be managed by an appropriate specialist for further investigation and care.