Patients presenting with ulceration will often have other chronic illnesses such as diabetes mellitus and osteoarthritis. Compression therapy remains the mainstay of treatment for the majority of these patients, although in some it will be contraindicated. This article stresses the importance of assessment of ulcer aetiology and will discuss the treatment of patients with ulceration who have complex health needs, including those with diabetes, rheumatoid arthritis, haematological problems such as sickle cell anaemia, cardiac problems, and wounds caused by trauma.