If you have a wound below the knee and it is non healing for 2 weeks or longer it is important to seek advice and support for a healthcare professional. Immediate actions from National best practice guidelines tell us that if there are no signs of concern* then to cleanse the wound and skin, apply a suitable dressing with a reduced compression of up to 20mmhg such as a class 1 hosiery. A full assessment which will include taking a Doppler will be then performed within 14 days.

Signs of concern or red flags are and require medical attention:

• Infection of the wound or surrounding skin
• Gangrene to the wounds or feet which appears as a black, hard, dry covering. This may be due to a blockage of the arteries in the leg or foot
• Suspected DVT deep vein thrombosis
• Suspected skin cancer

A Doppler assessment involves taking the blood pressure of each arm and of the pulses in the foot to work out the flow of blood through the arteries in the leg and if there is any peripheral artery disease. The healthcare professional will use a device which records ultrasound through a probe onto the pules of the arm and feet. A blood pressure cuff will be used also. Your will be requested to lie as flat as you can for approx. 10-15 minutes beforehand. The procedure can take as little as a few minutes with new automated devices, or up to 20 minutes with handheld systems.

If the assessment indicates, you do have any element of arterial disease a referral to a specialist for further support should be made. If your readings are in the normal ranges but you do have issues with your venous system, then a plan of care can be made with you to decide the best pathway to suit your needs.

A referral to a vascular department for further investigations and possible venous corrective procedures should be discussed with you. If suitable this can prevent recurrence of venous disease in the future.

Compression therapy in the form of bandages, hosiery and wraps will aid your venous system and push the blood up through your legs when you move and activate your calf muscle pump. This will aid a good blood supply to promote wound / ulcer healing.

Various types of dressings can be used onto your wound under compression depending on the on-going assessment of your wound.