Evaluating the cost and efficacy of leg ulcer care provided in two large UK health authorities

Abstract

This study suggests that reductions in costs and improvements in healing rates can be sustained in a mature community leg ulcer clinic programme staffed by specialist leg ulcer nurses.

Management of venous leg ulcers

“…Having said that, leg ulcer services provided in hospitals often fail to appreciate how many patients with leg ulcers simply refuse to come to hospital, let alone consent to venous investigation or surgery 1 2. Few community patients are prepared to be referred for assessment of their underlying venous disease 12 5…”

“…Rates of healing have been shown to be improved and costs to be reduced when a coordinated service using research based protocols was introduced 1 2 5 11. Responsibility for patient care should not be removed from community nurses; they should be provided with resources and training aimed at delivering an appropriate, high quality service in specialist leg ulcer clinics.…”

“…Community leg ulcer clinics using compression bandaging have dramatically improved healing rates and reduced costs, but close supervision by leg ulcer nurse specialists is essential if standards are to be maintained 1 2 5. We have reviewed the evidence for this approach and on new treatments that may improve care of leg ulcers in the future.…”

Surgery in Congential Lymphedema: A Follow-Up of 50 Years

“…13 Microsurgical methods developed later have been used for limited secondary lymphedema only. 14 Since the original data files were lost in our case, we can only speculate that the Watson-Servelle procedure might have been performed. Surgery, however, was responsible of ankylosis in the ankle joint and elephantiasis of the upper left leg.…”

The Difficult Venous Ulcer: Case Series of 177 Ulcers Referred for Vascular Surgical Opinion following Failure of Conservative Management

“…[9][10][11] By virtue of having failed conservative community and specialist ulcer clinic management, this patient group represent a resistant leg ulcer population, and this was reflected in the relatively low healing rate of 48% in this study. Our subgroup analysis of ulcers that had been present for over 1 year suggests history of DVT and widespread deep reflux are factors that are associated with long-term ulceration.…”