This resource has been developed to help nurses and primary care staff identify patients at risk of lower limb wounds and deliver safe, early interventions. It explains how to follow National Wound Care Strategy guidance, carry out red flag checks, start mild compression therapy when appropriate and educate patients on ongoing care. The aim is to prevent deterioration, reduce venous ulceration and improve patient outcomes.

• Identifying immediate and necessary lower limb care
• Introduction
• Background to the wound care crisis in the UK

Primary care nursing staff are often the first point of contact for patients who may be at risk, or who have current lower limb complications, which could develop into ulceration or poor skin integrity.

• Identifying patients at risk of poor lower limb health
• Mild swelling and signs of early venous disease
• Telangiectasis spider veins
• Varicose veins
• Pregnancy and lower limb swelling
• Individuals presenting with a lower limb wound
• Structured wound assessment
• Red flag assessment

If a patient has a lower limb wound, the National Wound Care Strategy Programme's leg ulcer recommendations advise the following immediate action.

• Immediate care of the lower limb

For those without red flags symptoms or conditions, offer mild graduated compression (British Standard Class 1: 14-17mmHg) and explain the reasons for compression therapy.

• Necessary care of the lower limb
• Compression hosiery
• Appropriate limb shape and profile
• Measuring for hosiery
• Donning and doffing
• Referrals
• Patient education
• Ongoing assessment and red flags

Early identification and intervention in lower limb wounds is vital to prevent deterioration and reduce the risk of venous ulceration. When red flags are excluded, mild compression therapy can be safely started in primary care to support healing and improve outcomes.

• Conclusion and lower limb care summary pathway
• Lower limb care summary pathway