Chronic skin ulcers: venous, arterial, neuropathic and traumatic
Telling venous, arterial, neuropathic, pressure and atypical ulcers apart at the bedside, ABPI and toe pressures, offloading and infection in the diabetic foot, skin tears in older people, and when to biopsy.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- A chronic ulcer is one that hasn't progressed to healing within about 4 to 6 weeks. Most are on the lower leg or foot, in older people.
- Venous disease causes about 70%, arterial or mixed disease most of the rest. In diabetes, neuropathy and ischaemia drive foot ulcers.
- Every leg ulcer needs an arterial assessment (pulses, ABPI, toe pressures if diabetic) before compression.
Loading the rest of the note…
Finished reading?
Sources
- Australian and New Zealand clinical practice guideline for prevention and management of venous leg ulcersAU/NZAustralian Wound Management Association (now Wounds Australia) and New Zealand Wound Care Society, 2011 (no newer ANZ edition found, November 2026)
- Therapeutic Guidelines: Ulcer and Wound Management, and DermatologyAU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (topic version not verified)
- Australian evidence-based guidelines for the prevention and management of diabetes-related foot disease: a guideline summary. Med J Aust 2023AU/NZDiabetes Feet Australia and Australian Diabetes Society, 2021 guidelines, MJA summary 2023 (no newer Australian edition found, November 2026)
- Schaper NC et al. Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update). Diabetes Metab Res Rev 2024;40:e3657International Working Group on the Diabetic Foot, 2023 (current; no later IWGDF update found, November 2026)
- Senneville E et al. IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023). Clin Infect Dis 2023IWGDF and Infectious Diseases Society of America, 2023
- Conte MS et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg 2019;69:3S-125SSociety for Vascular Surgery, ESVS and World Federation of Vascular Societies, 2019
- Gohel MS et al. A randomized trial of early endovenous ablation in venous ulceration (EVRA). N Engl J Med 2018;378:2105-14New England Journal of Medicine, 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy