Optimal care of leg ulcers and pressure sores does not depend simply on the choice of dressing. The cause of the wound must be investigated, and other systemic factors related to wound healing must be assessed, then the wound environment can be evaluated and the most suitable dressing applied. Georgina casey looks at these three steps to good wound care

Patients with chronic wounds such as pressure sores and leg ulcers pose many challenges to nurses caring for them. There are many causes of chronic wounds and numerous articles and text books discuss these in detail (1, 2, 3). Whatever their initial cause, chronic wounds usually result from a lack of oxygen and nutrients to the tissues involved. In pressure sores, the pressure on surrounding tissues depletes the blood supply and causes death of a region of tissue. In leg ulcers, the hypoxia results from arterial or venous obstruction.