Abstract
Objective:
To evaluate the influence of a specialized vascular-led community leg ulcer service on assessment and diagnosis of leg ulcers.
Design:
Before-and-after study with prospective and retrospective data collection.
Setting:
East Gloucestershire, England, UK.
Subjects:
Patients treated for chronic leg ulcers before and within a specialized service incorporating a one-stop assessment including ankle–brachial pressure index (ABPI) and colour venous duplex.
Main outcome measures:
The means of assessment and the identified aetiology of leg ulcers in community patients.
Results:
Before clinics, only 40 (26%) limbs had a diagnosis recorded. After clinics, 83 (21%) limbs had arterial disease, including 64 (16%) with mixed arterial/venous disease. Venous duplex identified 279 (70%) limbs with venous disease of which 121 (43%) had superficial venous disease alone.
Conclusion:
A one-stop assessment clinic with ABPI and colour venous duplex ultrasound within a specialized community service improves diagnosis of leg ulcers. This is essential before appropriate and safe management by specialist nurses in the community.
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