Martorell hypertensive ischaemic leg ulcer The ulcer nobody is talking about……but should

Wound healing refers to a person’s ability to restore tissue that has been compromised. In chronic wounds, there is a significant delay in this restoration process and this delay can be due to various intrinsic (underlying comorbidities) or extrinsic (environment, positioning) factors found in a patient. The first step in the assessment of a clinical wound is to distinguish between chronic and acute wounds; this is easily done by taking a comprehensive history during consultation. A comprehensive medical history will include: • current wound history (onset, causal factors, pain, size, drainage, current wound care), • prior wound history (similar wounds in the past, how long did they take to heal), • medical history (comorbidities such as hypertension, diabetes, kidney disease, nerve involvement), • social history (cigarette smoking, alcohol use, nutritional status, obesity, age), and • surgical history (previous wounds with delayed healing, surgery to manage non-healing, grafting, ablation of veins, vascular surgery).