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Leg ulcer - venous - Management
How do I manage oedema associated with venous leg ulcers?

  • In addition to compression bandaging (if appropriate), advise the person to elevate their legs (above hip level) for 30 minutes, three to four times a day, and consider placing pillows under their feet and legs while sleeping.
  • Do not prescribe diuretic medication for persistent or worsening oedema: check compliance with advice given regarding reducing oedema, and exclude other causes of oedema such as medication and heart failure.
Clarification / Additional information
  • Prolonged periods of time with legs down (e.g. sitting, standing) as opposed to elevated, and immobility, all contribute to leg oedema.
  • Bed rest and elevation may reduce oedema of the ankle and leg before compression bandages are applied.
Basis for recommendation
  • These recommendations are based on clinical guidelines: The nursing management of patients with venous leg ulcers published by the Royal College of Nursing [RCN, 2006], together with the best available trial evidence, informed expert opinion, and current good clinical practice [Simon et al, 2004].
  • Leg elevation encourages venous return and may reduce pain and leg swelling.
  • Diuretics are not beneficial for dependent leg oedema and may result in renal impairment. Nevertheless, diuretics may be indicated for oedema related to other causes such as heart failure. For more information see the CKS topic on Heart failure - chronic.

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