Finding the cause first
Every wound is assessed with duplex ultrasound and ankle pressure measurement to establish whether the problem is venous, arterial, diabetic, pressure-related or something rarer. Treating the cause is what heals the wound.
What treatment involves
- Graduated compression, correctly fitted, for venous ulceration
- Restoring arterial blood flow where the circulation is inadequate
- Bridge VAC negative-pressure therapy combined with compression — a technique developed and published by Prof Sultan's team
- Hyperbaric oxygen medicine for refractory wounds
- Debridement, skin grafting and specialist dressings
- Treating the underlying veins to stop the ulcer coming back
