Condition Guide · Sheffield Vein Clinic

Venous Leg Ulcers in Sheffield

A venous leg ulcer is the most advanced complication of untreated venous disease — but clinical evidence strongly supports early venous intervention to accelerate healing and prevent recurrence. Prof Steve Goode, NHS Consultant Interventional Radiologist, offers specialist assessment and treatment at Sheffield Vein Clinic on Ecclesall Road.

Consultant-Led Assessment

Prof Goode assesses every patient personally

Duplex Ultrasound Included

Venous anatomy mapped at your first appointment

EVRA Trial Evidence

Early venous intervention accelerates healing

No GP Referral Needed

Send your enquiry directly to Sheffield Vein Clinic

Transparent Pricing

Full cost confirmed before any procedure

Recognising a Venous Leg Ulcer

A venous leg ulcer is an area of broken skin on the lower leg that fails to heal because of persistently elevated venous pressure. It is the most advanced stage of chronic venous disease — but it is not the end of the road.

Many patients with venous leg ulcers are managed with dressings and compression bandaging alone, without anyone investigating or treating the underlying venous disease. This is changing — clinical trial evidence now clearly demonstrates that early venous intervention dramatically improves healing rates.

An open wound on the lower leg — most commonly around the inner ankle
A wound that has been present for more than two weeks without signs of healing
Surrounding skin that is discoloured, hardened or thickened (lipodermatosclerosis)
Venous eczema — itchy, inflamed skin around the ulcer or surrounding leg
A history of varicose veins or leg swelling in the affected leg
Previous episodes of ulceration that have healed and then recurred
Pain — often a dull, persistent ache rather than sharp pain

Patients across Sheffield, South Yorkshire and North Derbyshire with venous leg ulcers can access specialist assessment at Sheffield Vein Clinic on Ecclesall Road. Prof Goode will assess the venous anatomy, review the wound and recommend the most effective treatment plan. No GP referral is required.

What Causes Venous Leg Ulcers?

Venous leg ulcers develop as the end result of sustained elevated venous pressure — almost always caused by underlying venous reflux disease.

The pathway from venous reflux disease to leg ulceration follows a well-understood progression. Valve failure in the saphenous veins causes blood to pool in the lower leg, raising venous pressure. Over time, this sustained hypertension impairs the exchange of oxygen and nutrients between blood and tissue — causing the skin to break down and fail to heal.

In many patients, venous leg ulcers are triggered by a minor injury — but the ulcer persists because the underlying venous disease prevents normal tissue healing. Wound dressings and compression can help manage the ulcer surface, but cannot resolve the venous hypertension that is driving it.

The typical progression

Venous reflux develops → Blood pools in lower leg veins
Venous hypertension increases → Fluid leaks into surrounding tissue
Skin changes occur → Discolouration, hardening, venous eczema
Skin breaks down → Venous leg ulcer forms
Ulcer fails to heal → Persistent wound, infection risk, recurrence

Most Venous Ulcers Have a Treatable Cause

In the majority of patients with venous leg ulcers, duplex ultrasound identifies significant superficial venous reflux that is amenable to minimally invasive treatment. Closing the incompetent vein reduces the venous pressure driving the ulcer — and clinical trials demonstrate this accelerates healing and reduces recurrence.

How Is a Venous Leg Ulcer Assessed?

Effective management of a venous leg ulcer requires assessing both the wound and the underlying venous anatomy — in the same appointment.

At your initial consultation, Prof Steve Goode will examine the ulcer, assess the surrounding skin and perform a duplex ultrasound examination of the leg veins. This identifies the incompetent venous segments responsible for the raised venous pressure — and determines whether venous intervention is appropriate and likely to accelerate healing.

An ankle-brachial pressure index (ABPI) measurement is also performed — confirming the wound is venous rather than arterial in origin, and that compression therapy is safe to apply.

The landmark EVRA trial demonstrated that early venous intervention — performed while the ulcer is still open, rather than waiting for it to heal first — results in significantly faster healing. Prof Goode will advise on the most appropriate timing for intervention based on your individual clinical assessment.

Wound assessment and classification of ulcer characteristics
Ankle-brachial pressure index (ABPI) — confirming venous vs arterial cause
Duplex ultrasound mapping of the superficial and deep venous systems
Treatment plan — venous intervention, wound management and compression

EVRA Trial Evidence

The EVRA randomised controlled trial demonstrated that early endovenous ablation — performed while the ulcer remains open — led to significantly faster ulcer healing compared to deferred intervention. This is the clinical evidence underpinning the approach at Sheffield Vein Clinic.

Why Venous Leg Ulcers Need Specialist Assessment

Without treating the underlying venous disease, venous leg ulcers have very high recurrence rates — and each recurrence is harder to heal than the last.

WITHOUT VENOUS TREATMENT

Compression Alone

Compression bandaging and wound dressings can encourage healing — but without treating the underlying venous hypertension, recurrence rates within five years are reported at around 70% in clinical literature.

WITH EARLY VENOUS TREATMENT

EVLA + Compression

The EVRA trial demonstrated that early endovenous ablation — performed with the ulcer open — resulted in faster healing and significantly reduced recurrence. This is the standard recommended approach at specialist vein centres.

DELAYED OR MISSED TREATMENT

Chronic Recurrent Ulceration

Repeated episodes of ulceration cause progressive skin and tissue damage, increasing pain, reducing mobility and significantly impacting quality of life. Earlier specialist referral and venous intervention breaks this cycle.

If you or someone you care for has a venous leg ulcer, early specialist assessment and treatment of the underlying veins can make a significant difference to healing and long-term quality of life.

Treatment Options for Venous Leg Ulcers

Effective management requires addressing both the wound and the underlying venous disease.

The primary aim of venous intervention is to close the incompetent vein responsible for the raised venous pressure — reducing that pressure so that the wound can heal and reducing the risk of future recurrence.

EVLA — Endovenous Laser Ablation

The primary treatment for venous leg ulcers with underlying saphenous reflux. EVLA closes the incompetent vein under ultrasound guidance — reducing venous pressure and creating the conditions for wound healing. Performed with the ulcer open if appropriate.

Foam Sclerotherapy

Used alongside or following EVLA to treat varicose tributaries contributing to venous hypertension. Ultrasound-guided foam sclerotherapy targets secondary vessels as part of a comprehensive venous treatment plan.

Compression Therapy

High-grade graduated compression is essential in venous leg ulcer management — both as a healing adjunct and for long-term prevention of recurrence. Prof Goode will advise on appropriate compression alongside any venous procedure.

View all treatments →

Why See Prof Steve Goode for Venous Leg Ulcers in Sheffield?

NHS Consultant Interventional Radiologist. Newly appointed Professor. The specialist who sees — and treats — every patient personally.

Prof Steve Goode is a Consultant Interventional Radiologist at Sheffield Teaching Hospitals NHS Trust and newly appointed Professor — bringing NHS subspecialty expertise in image-guided vascular procedures to Sheffield Vein Clinic on Ecclesall Road.

Interventional Radiology pioneered the minimally invasive, ultrasound-guided techniques now used as the gold standard in vascular medicine. Prof Goode is research-active — his clinical practice is informed by current evidence, not historical protocols.

Sheffield Vein Clinic serves patients across Sheffield, Rotherham, Barnsley, Chesterfield, Doncaster and wider South Yorkshire. No GP referral required.

Duplex ultrasound performed personally by Prof Goode at every first consultation
Assessed and treated personally — not passed to a junior clinician
NHS Consultant and Professor — research-active, evidence-based care
Full range of vein treatments available at Sheffield Vein Clinic
Continuity of care — the same consultant throughout your treatment
Transparent pricing — full cost confirmed before you proceed

Frequently Asked Questions

Answers to the questions patients across Sheffield and South Yorkshire ask most often.

Will my venous leg ulcer heal without treating the underlying veins?

Many venous leg ulcers can heal with compression alone, but recurrence rates without treating the underlying venous reflux are very high — around 70% within five years in clinical studies. Treating the incompetent veins with EVLA significantly reduces recurrence and, if performed early, accelerates the initial healing of the open ulcer.

How do I know if my leg ulcer is venous rather than arterial?

Venous ulcers typically occur around the inner ankle, are associated with surrounding skin changes (discolouration, thickening), and the pain — when present — often improves with elevation. Arterial ulcers tend to occur more distally, on the toes or foot, and worsen with elevation. Assessment including ankle-brachial pressure index measurement will differentiate the cause. Prof Goode performs this assessment at your consultation.

Can I have EVLA if I have an open leg ulcer?

Yes — and the EVRA trial demonstrated that early EVLA performed while the ulcer is open results in faster healing compared to waiting for the ulcer to close before treating the veins. Prof Goode will advise on the most appropriate timing based on your individual clinical assessment.

How long have I had to have an ulcer before seeking specialist help?

You should seek specialist assessment promptly — the sooner the underlying venous disease is treated, the faster healing is likely to occur and the lower the risk of recurrence. Long-standing ulcers can still benefit substantially from venous intervention. There is no minimum duration before seeking help.

Do I need a GP referral to be seen at Sheffield Vein Clinic for a leg ulcer?

No — you can enquire directly. If you are currently under a tissue viability nurse or wound clinic, please let us know and bring any relevant wound care documentation to your appointment. Prof Goode will liaise with your existing care team as appropriate.

What compression should I be wearing with a venous leg ulcer?

The appropriate compression depends on the ABPI result and the clinical assessment. Multi-layer compression bandaging is typically used for active ulcers, transitioning to high-grade compression hosiery once healed. Prof Goode will advise on appropriate compression as part of your management plan.

Specialist Help for Venous Leg Ulcers in Sheffield

Early specialist assessment and treatment of the underlying veins can make a significant difference to healing and quality of life. Request a consultation with Prof Steve Goode today.

Sheffield Vein Clinic · 772–774 Ecclesall Road · Sheffield. No referral required. Serving South Yorkshire and North Derbyshire.

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