Leg Ulcers: A Cross-Sectional Survey of Management Practices and Treatment Costs in Ireland

Abstract

Objective:

To review the management and the cost of leg ulcers.

Design:

Cross-sectional survey based on a questionnaire completed by healthcare workers caring for patients with leg ulcers in a defined population.

Setting:

The Mid-Western Health Board area in Ireland with a population of 317069.

Patients:

All patients receiving healthcare for active leg ulceration.

Results:

Leg ulcers were recorded for 389 individuals and public health nurses primarily provided care (n = 283). Patients had open ulcers for a median period of 8 months (interquartile range: 3 months — 2 years) with almost half (n = 181) reporting previous episodes of ulceration. Fifty different dressing products were used to treat leg ulcers in the region. Only 52.2% (203/389) of patients had the aetiology of their leg ulcers properly investigated and evidence-based care was generally apparent in this group. Otherwise, care appeared haphazard and at times inappropriate. The estimated annual direct cost of dressing leg ulcers was £585 660.

Conclusion:

A regional strategy for managing leg ulcers needs to be clarified and implemented if practitioners are to incorporate evidence-based care into routine work.