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Leg Ulcer

Leg ulcers are treated by different forms of dressings by the family physicians. It is extremely important to know what the cause for the ulcer is? 80% 0f the ulcers in the legs are due to vascular insufficiency. Healing and preventing recurrences can only be achieved by correcting the vascular cause. Dressings do play an important role in aiding ulcer healing.

Leg Ulcer


Venous Ulcer

Venous Ulcer

Causes of Venous Ulcers

Pathophysiology of Venous Ulcer

Initial Assessment

Treatment of Venous Ulcer


Following extensive randomised controlled studies, involving different dressing types used in conjunction with the four layer bandage, it was found that dressings had little influence on ulcer healing. 

Therefore, a simple low adherent dressing such as Sofratule, Inadine is used

Leg Ulcer

Four layer Compression Bandaging

Graduated Compression Has Shown to

Stemmer et al

All bandages used are 10 cms. in width and should be applied from the base of the toes to the knee joint.

Layer I

Orthopaedic wool

  • This is used to absorb exudate and redistribute pressure around the ankle, protecting the bony prominences from excessive pressure.
  • It also fills in the troughs behind the malleoli where little pressure is exerted.
  • The bandage is applied without tension in a loose spiral.
Leg Ulcer

Layer II

Cotton crepe

  • Its main function is to increase absorbency and to smoothen the orthopaedic wool layer, thereby preserving the elastic energy of the main compression layers.
  • The crepe is also applied in a spiral.
Leg Ulcer

Layer III

Elasticated crepe

  • This is the most important layer achieving compression.
  • It is applied at mid-stretch in a figure of eight with a 50% overlap.
Leg Ulcer

Layer IV


  • It is a lightweight, elastic, cohesive bandage.
  • It maintains the four layers in place and adds durability to the system.
  • It is applied at mid-stretch with a 50% overlap.
Leg Ulcer


Dr. Pankaj Patel a vascular surgeon has expertise in peripheral vascular diseases, varicose veins and deep vein thrombosis