• Change in quality of life [ Time Frame: Telephone call every 2 weeks, on-site visit at 2.5 and 5 months. ] [ Designated as safety issue: No ]
• Change in satisfaction with care [ Time Frame: Telephone call every 2 weeks, on-site visit at 2.5 and 5 months. ] [ Designated as safety issue: No ]
• Adherence with self-management goals [ Time Frame: Telephone call every 2 weeks, on-site visit at 2.5 and 5 months. ] [ Designated as safety issue: No ]

The purpose of this study is to determine whether individualized wound prevention instructions will lengthen the ulcer-free period in veterans with recently healed venous ulcers.

Venous ulcer disease is the most common form of lower extremity ulcer, and treatment requires months to years of costly intervention. Preventing venous ulcers from recurring is ideal, however, healing time is variable, possibly due to inadequate patient/clinician communication and surveillance. An aftercare summary is a detailed set of self-care instructions designed to help patients understand and influence preventative factors under their control. They have successfully been used in patients with cardiac disease and are currently being tested to help prevent diabetic foot ulcers. We propose the use of an aftercare summary to help prevent ulcer recurrence in veterans with recently healed venous ulcers.

• Experimental: Will receive usual wound prevention care, aftercare summaries, and regular surveillance.
• No Intervention: Will receive usual wound prevention and surveillance only.
• No Intervention: Will receive usual wound prevention only.

Inclusion Criteria:

• Confirmed venous ulcer (ICD-9: 454.0, 454.2, 459.11, 459.13, 459.31, 459.33);
• Documented healing of all lower extremity ulcers;
• Ankle-brachial index (ABI) > 0.8 to rule out arterial insufficiency

Exclusion Criteria:

• Unwilling or unable to sign informed consent;
• No plans to seek care at VA Puget Sound within 6 months;
• Limbs with ulcers or threatened viability