Venous disease Resources

Although it may not attract as much attention as other medical areas, the pandemic has had a huge impact on wound care services with many traditional routes of practice compromised during life in lockdown. But, while this continues to add pressure on the nursing community, it also offers an opportunity to retain the recent step change in innovation to tackle backlogs and build back stronger.

This article is the second in a two-part series on managing common lower limb problems encountered in primary care. The first article in the series (Brown, 2017) discussed the causes of oedema and its relation to underlying conditions, such as venous disease, lymphoedema and lipoedema. This article investigates skin care, the management of ‘wet legs’ and the different types of compression therapy available to non-specialist community nurses.

In patients with venous and lymphovenous disease, skin changes to the lower limb(s) occur gradually, and become more serious over time if left untreated. The CHRonic Oedema Signs and Symptoms (CHROSS) Checker is a tool kit consisting of an assessment chart and key cards that have been developed to help clinicians easily identify the skin changes that occur as a result of underlying venous and lymphovenous disease, when carrying out holistic patient assessment. It also provides clear guidance on which compression products can be used to manage the disease type and severity of skin change. For clinicians unfamiliar with some or all of the signs and symptoms listed on the CHROSS Checker chart, the key cards contain further information in the form of a photograph, definition and cause of each sign and symptom listed. This article will describe the theory behind the development of the CHROSS Checker tools and explain how to use them in clinical practice.

Janice Bianchi, Independent Medical Education Specialist and Honorary Lecturer, Glasgow University