ABSTRACT
The diagnosis and treatment of the underlying cause of a leg ulcer are as important as the treatment of the ulcer itself. A failure to appreciate this elementary concept is responsible for the majority of recurrent ulcers. Even when this point has been grasped, accurate diagnosis may be hampered by lack of familiarity with methods of investigation. The most frequent error is the failure to recognize that an ulcer is ischemic in origin, and many ischemic ulcers are undoubtedly made much worse by tight compression bandaging, in the mistaken belief that they are venous. As the latter are by far the most common, this is an understandable mistake, but in an aging and cigarette-smoking society, ischemic ulceration is now seen with increasing frequency.
