International guidelines recommend that specialist help should be sought in the following situations⁽¹⁾⁽²⁾
• Wound, such as leg ulcers, of unknown cause—uncertainty always requires further investigation before appropriate treatment can be implemented
• Patients with complex comorbidity, such as diabetes, renal failure and rheumatoid arthritis, should be monitored by an appropriately trained specialist
• Wounds that are static or have not responded to four weeks of standard treatment should be referred to an appropriately trained specialist
• A rapid deterioration in a wound is most likely to be due to ischemia or infection. These wounds should be immediately referred to a specialist.