This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in


Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team


Venous ulcers are usually diagnosed clinically without additional vascular investigations (1). Suspicion of arterial disease requires a vascular workup.

  • Ankle Brachial Pressure Index (ABPI)
    • will identify the presence or absence of significant peripheral arterial disease (PAD)
    • compression therapy may be safely used in leg ulcer patients with ABPI≥0.8
    • patients with an ABPI of <0.8 should e referred for a specialist vascular assessment (2)

In addition the following investigations are carried out in venous ulcer patients:

  • serial measurement of the ulcer surface area - indicates the rate of healing or failure to progress
  • bacteriological swabbing
    • should only be taken where there is clinical evidence of infection e.g. - cellulitis, pyrexia, increased pain, rapid extension of area of ulceration, malodour, increased exudate
  • patch-testing using a leg ulcer series
    • for leg ulcer patients with associated dermatitis/eczema
  • biopsy
    • should be considered if the appearance of the ulcer is atypical or if there is deterioration or failure to progress after 12 weeks of active treatment

  • other tests
    • serum glucose (and, if elevated, HbA1c), cholesterol and triglycerides, iron, haemoglobin, erythrocyte sedimentation rate and differential leukocyte counts


1. Bonkemeyer Millan S, Gan R, Townsend PE. Venous Ulcers: Diagnosis and Treatment. Am Fam Physician. 2019 Sep 1;100(5):298-305.

2. Scottish Intercollegiate Guidelines Network (SIGN) 2010. Management of chronic venous leg ulcers

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.