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BMJ 2004;328 (5 June), doi:10.1136/bmj.328.7452.0-d
Most patients with venous leg ulcer can be managed in the community. Early identification of risk factors, along with a tailored approach with compression bandaging, leg elevation, improved mobility and nutrition, and close supervision by a specialist nurse, are important, say Simon and colleagues (p 1358). Up to 85% of ulcers are associated with venous hypertension, but surgery on the superficial veins is clearly indicated only for patients with superficial venous incompetence, and antibiotics have little effect on ulcer healing. The authors say that the focus should move from treatment to prevention.
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