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4C: Prevention

Once you have learned how to assess and manage an arterial leg ulcer, there are some important strategies that you can apply to reduce the risk of the leg ulcer from recurring. These may include the following:

StrategyExplanation
Protect the client’s lower legs and feet Protection of the lower legs and feet includes:
  • Ensuring shoes are well-fitting, soft and comfortable
  • Using leg protection devices to avoid injury (e.g. using limb protectors or long trousers)
  • Protecting the toes and heels of clients with decreased mobility by using effective pressure relief devices such as foam or gel pads
  • Being extremely careful when cutting toenails. Preferably, a podiatrist should do this.
Keep the client’s lower legs warm Passive warming of the lower legs and feet, such as covering the legs with a blanket, improves blood supply (perfusion) and may be of benefit in preventing arterial ulcers.
Follow up regularly and perform skin checks The key to preventing arterial leg ulcers from occurring or recurring is to check the client’s skin daily. If a problem is detected, start treatment as early as possible.
Moisturise the client’s skin Apply a pH neutral moisturiser to the client’s skin at least twice daily to keep the skin in good condition.
Encourage exercise Clients should do lower limb exercises, at least every hour. Simple exercises may include drawing figures with their toes, pushing their toes towards the floor and then pointing them up towards their nose, standing on the balls of their feet, tiptoeing up and down, walking, or swimming. Any movement of the calf muscle helps to improve the arterial blood supply.
Discourage the client from crossing his/her legs Crossing the legs reduces arterial blood flow.
Discourage smoking Smoking impairs blood flow.
Ensure the client maintains a healthy weight relative to their height Ensuring a well-balanced diet and healthy weight reduces the risk of arterial disease.
Manage any underlying diseases Ensuring that underlying diseases such as diabetes, heart disease, high blood pressure are well controlled helps to prevent complications such as arterial leg ulcers.
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