Leg ulcer (comorbidities, nutritional status)

Fasting laboratory tests

• FBC (anaemia)
• Fasting plasma glucose (if no known diabetes)
• Serum albuminif neededPrognostic markers, with CRP helping to interpret albumin. Two French series: biological protein malnutrition in 48.5% of 66 patients hospitalised for a non-healing ulcer, not predictable from history or examination ^[2]; low serum albumin associated with wound worsening at 12 weeks in 41 outpatients ^[3]. HAS does not list these tests ^[1].
• CRPif neededPrognostic markers, with CRP helping to interpret albumin. Two French series: biological protein malnutrition in 48.5% of 66 patients hospitalised for a non-healing ulcer, not predictable from history or examination ^[2]; low serum albumin associated with wound worsening at 12 weeks in 41 outpatients ^[3]. HAS does not list these tests ^[1].
• Not a laboratory test: ankle-brachial pressure index (ABPI) in every patient with a leg ulcer; venous duplex ultrasound.

Local sample

• Bacteriological sample from the wound after cleaning (if infection worsens or does not improve on antibiotics)if needednon-French guidelineNICE (2020) advises against any sample at the first visit, even if the ulcer looks infected, and has it considered, after cleaning, if the infection worsens or does not improve as expected ^[4]. The Chinese consensus (2025) then prefers a wound base biopsy, the swab poorly distinguishing colonisation from deep infection ^[5]. HAS advises against routine sampling and notes the absence of consensus on its indications, empirical antibiotic therapy possibly being preferred ^[1].