Early vascular assessment should be carried out

EDITOR,—Deborah A Simon and colleagues' study provides further evidence supporting the role of community based clinics in the management of leg ulcers.1 These specialised local clinics provide skill in managing leg ulcers close to patients' homes and have influenced healing and cost effectiveness.2 Our only concern with this study is that no patient was referred for venous investigation or surgery. We, like others, have shown that superficial venous disease alone is present in about half of patients with venous ulceration. …