Chronic leg ulceration is a major health problem in the UK costing the NHS up to £600 million per annum. In Western countries, 1–2% of the population is likely to have a chronic leg ulcer at any one time; this increases to 3% in those over 65 years old. Studies have found that 60–80% of chronic leg ulcers have a venous component and 10–30% are associated with arterial insufficiency. The natural history of the disease is a continuous cycle of breakdown and healing over decades. As a result, ulcer healing rates can be poor with up to 50% of venous ulcers open and unhealed for 9 months. Most of the clinical management falls to primary care with over 80% of leg ulcer cared for in the community.
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