Cardiovascularmiddle twist
A 72-year-old woman presents with an ulcer above her left medial malleolus that has been present for eight weeks. She has type 2 diabetes and smoked a packet of cigarettes daily for 40 years. The ulcer is shallow with an irregular sloping edge and a granulating base; the surrounding skin is brown-stained, firm and tight. She has prominent tortuous veins in both legs and says the ache in the leg eases when she puts her feet up on a stool. Which one of the following is the most appropriate next step in management?