Libby, a 91-year-old regular practice patient, presents with a one-month history of increasingly painful bilateral lower leg ulcers.

She has multiple ulcers of approximately 2cm in diameter on the anterolateral aspect of both legs.

They are a few millimetres deep with slough at the bases (see figure 1).

Libby reports that the ulcers have been increasing in size and pain despite her application of simple dressings at home.