chronic leg ulcer [Gk, chronos, time; ONorse, leggr + L, ulcus, ulcer] , a wound of the lower extremity persisting for more than 6 weeks and showing no signs of healing after 3 or more months. It is typically associated with varicose veins, deep venous insufficiency, or a similar circulatory obstacle. Nonvenous causes of leg ulceration include arterial disease; ulcers may also be caused by trauma or have a bacterial, mycotic, hematological, neoplastic, neurological, or systemic origin. ▪ OBSERVATIONS: Appearance will vary, and can include complete loss of the epidermis and often portions of the dermis and even subcutaneous fat. The ulcer may be painful and have a foul odor. ▪ INTERVENTIONS: Usually, treatment includes elevation of the leg two or three times daily, elastic support applied to the limb of the ambulatory patient, and avoidance of maceration of the wound. Because many factors lead to the development of the ulcer, it is important to have the input of the interdisciplinary team in the long-term management and treatment plan. ▪ PATIENT CARE CONSIDERATIONS: Leg ulcers can be debilitating and greatly reduce patients’ quality of life. A well-coordinated approach to delivering the correct treatment option for individual patients, based on accurate assessment of the underlying pathophysiology, is essential.
