Chronic leg ulcer: does a patient always get a correct diagnosis and adequate treatment?

Abstract

Patients with chronic leg ulcers have severely impaired quality of life and account for a high percentage of annual healthcare costs. To establish the cause of a chronic leg ulcer, referral to a center with a multidisciplinary team of professionals is often necessary. Treating the underlying cause diminishes healing time and reduces costs. In venous leg ulcers adequate compression therapy is still a problem. It can be improved by training the professionals with pressure measuring devices. A perfect fitting of elastic stockings is important to prevent venous leg ulcer recurrence. In most cases, custom-made stockings are the best choice for this purpose.

The role of compression therapy in the treatment of venous leg ulcers

“…It involves employing external and layered pressure, using special bandages, ready-to-use layered compression bandage systems, and, in the case of small ulceration which does not weep, compression stockings. 3,7,36,52,53 A systematic literature review shows that every form of properly employed compression favorably influences the process of venous ulceration healing, and it is difficult to determine which method is the most effective. 25,34,54 In the research carried out by Szewczyk among 112 people suffering from venous ulcers, the healing dynamics of ulceration treated with 2-and 4-layer compression system was comparable.…”

General practitioners’ perceptions of their role and their collaboration with district nurses in wound care

“…Several studies, both Swedish and international, have identified shortcomings in the wound care provided in primary care, in particular in relation to the assessment of wounds (McGuckin and Kerstein, 1998; Öien and Ragnarson Tennvall, 2006; Mooij and Huisman, 2016). It has been found that, in primary care, wounds are generally treated without an established aetiologic diagnosis, which is thought to be due to insufficient collaboration between GPs and DNs (Friman et al ., 2010; Sinha and Sreedharan, 2014; Mooij and Huisman, 2016).…”

“…Further barriers to collaboration that are emphasised include organisational factors such as lack of clarity regarding leadership, status, professional socialisation and responsibility for decisions (Baranoski, 1992; Whitehead, 2007; Milburn and Colyer, 2008; Xyrichis and Lowton, 2008). In general, there appears to be lack of definition regarding roles and sharing of responsibility, which clearly impedes collaboration in primary care (McInnes et al ., 2015; Mooij and Huisman, 2016).…”

Implementing clinical process management of vascular wounds in a tertiary facility: impact evaluation of a performance improvement project

“…In order to supply the optimal standard of care it is therefore imperative to review and enhance practice on different levels, from the reality of a unit to the relationships with the different health care organizations involved. 20 As far as our unit is concerned, this will constitute the future development of the implementation process. In order to do so we plan on setting collaboration with the national health system to enhance data collection and audit on the incidence and prevalence of vascular wounds across the province.…”