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Management of leg ulcers - 2

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VOL: 96, ISSUE: 43, PAGE NO: 45

JUNE JONES, CLINICAL NURSE SPECIALIST IN LEG ULCERS, CHURCHTOWN COMMUNITY CLINIC, SOUTHPORT, MERSEYSIDE

The ankle brachial pressure index (ABPI) for each leg is calculated by dividing the highest of the ankle pressures by the higher of the two brachial pressures. Service guidelines tend to recommend that a patient with an ABPI of less than 0.8 should be referred for routine vascular opinion; an ABPI of less than 0.5 suggests an urgent referral is required as it is indicative of severe arterial disease.

The ankle brachial pressure index (ABPI) for each leg is calculated by dividing the highest of the ankle pressures by the higher of the two brachial pressures. Service guidelines tend to recommend that a patient with an ABPI of less than 0.8 should be referred for routine vascular opinion; an ABPI of less than 0.5 suggests an urgent referral is required as it is indicative of severe arterial disease.

Compression therapy is currently recommended for all patients with a venous ulcer and an ABPI of 0.8 or greater (RCN, 1998).

The ABPI in patients with diabetes or atherosclerosis can be elevated owing to calcification of the medial layer of the artery. This makes the underlying arteries resistant to compression and can result in a falsely high reading. In such cases compression should be used with caution.

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