The second in this four-part series exploring leg ulcer management and understanding compression therapy examines the role of assessment as the basis for optimal clinical practice. The authors explore how the findings of thorough assessment can influence treatment choice. Adopting an holistic, person-centred approach to assessment, which includes taking an ankle brachial pressure index (ABPI) reading and involves the patient in decision-making will help nurses to make effective clinical decisions and plan care in partnership with patients. This article discusses a three-stage assessment and clinical decision-making process, which involves looking at the whole person, assessing the leg and the wound. The next article in the series will examine compression hosiery and adjustable wraps for the management of the lower limb.
Chronic leg ulceration is an increasing burden in the UK, both financially to the health service and on a human level. This first article in a four-part series, which looks at leg ulcer management and understanding compression therapy, explores the cardiovascular system, the underlying causes of lower limb problems, and the risk factors for leg ulceration. An overview of how compression therapy works and an introduction to the options available for patients and clinicians in this field of practice is also given. Subsequent articles in the series will look at holistic assessment and clinical decision-making in leg ulcer management, understanding compression hosiery and adjustable wraps, as well as compression bandaging and skin care
Chronic oedema is a soft tissue swelling present for at least three months, most commonly caused by venous and lymphatic impairment. It has a huge impact on quality of life and over time may cause social deprivation. The mainstay of treatment is compression therapy and treatment of the underlying cause. Comfort and acceptability of the compression system is essential. Clinicians need to work with patients to ensure that they are included in treatment decisions and empowered to take charge of their condition.
Louise Brereton, Pauline Barber & Brenda King discuss the adequacy of educational provision for nurses involved in managing patients with leg ulcers.
Rosemary Pudner considers the issues involved when managing a patient with a leg ulcer.
Maureen Barrett discusses the treatment of primary lymphoedema.
Maureen Barrett RGN is a Community Staff Nurse, Fareham, Portsmouth.
Article accepted for publication February 2002
