Update: Venous leg ulcer healing could improve thanks to a new assessment system

VOL: 103, ISSUE: 15, PAGE NO: 36

An assessment tool to predict venous leg ulcer healing has been developed at CheltenhamGeneralHospital's Department of Vascular Surgery. The authors suggest it will help give more accurate prognosis information for patients and may help guide service provision.

An assessment tool to predict venous leg ulcer healing has been developed at CheltenhamGeneralHospital's Department of Vascular Surgery. The authors suggest it will help give more accurate prognosis information for patients and may help guide service provision.

The study showed that patient age, ulcer chronicity and a venous refill time of 20 seconds or less (measured with a digital photoplethysmography - PPG) were risk factors for ulcer healing. These were then used to devise a formula to identify patients unlikely to respond to conventional treatment.

Judy Harker, nurse consultant in tissue viability at Penine Acute NHS Trust, Manchester, said: 'Given that venous leg ulcers are a common, chronic, recurring condition, the development of a tool to predict venous ulcer healing is welcomed by practitioners.

'PPG is not available in all leg ulcer services and is likely to be restricted to more specialist vascular/leg ulcer units, thus limiting the use of the tool in routine practice. Nonetheless, it could be argued that this study highlights the need for greater time and attention to be directed towards assessing venous competence within a limb, especially as venous refilling time had the greatest impact on healing.'

She noted that adding venous investigations to the baseline assessment of a patient with a leg ulcer would have resource implications for the health service.

Kulkarni, S.R. et al (2007) The Ulcerated Leg Severity Assessment score for prediction of venous leg ulcer healing. British Journal of Surgery;
94: 2, 189-193