Chronic and difficult wounds, including leg ulcers, are referred for evaluation and management. Medical evaluation is geared to finding the underlying illness and other causes for non-healing wounds. An appropriate wound care regimen is established and periodically adjusted. Many patients with chronic leg ulcers are seen weekly and treated with compression dressings. Other modalities include the use of skin substitutes and growth factors. Ancillary care may include visiting nurse and home lymphedema pump compression.