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Assessing and dressing ulcers

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Venous ulcers are the most common form of leg ulceration accounting for 60 to 80 per cent of all cases.1 They are caused by incompetent valves in the venous system which leads to oedema and pooling of blood in the lower limbs, and causes venous hypertension. If the patient is exposed to this for prolonged periods of time, changes in the skin and ulceration can result.

Treating leg ulceration is complex, time consuming and costly.2-4 The prevalence of leg ulceration has not decreased since the 1980s and the incidence rises with age: an estimated one in 50 people over the age of 80 experience an ulcer.4,5 A good level of knowledge around managing leg ulcers is required to successfully deal with this common problem.

Comprehensive assessment

Nurses should carry out an initial comprehensive assessment that includes ulcer history, previous treatment experiences, medical history, current medication, allergies, physical, psychological and social risk factors, baseline measurements of weight, blood pressure and urinalysis, presence of pain, level of mobility, level of patient understanding of the condition and ability to participate in the care.6

Medical records and family members should also be consulted. This will ensure the most effective plan of care is implemented, maximising the patient's potential for healing and achieving the best quality of life.

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Thank you.My leg ulcer was showing much improvement but over last four weeks is not as good. District nurses come weekly but continuity of care is lost as it may be a different nurse each week.Dressing type varies with nurses and l believe are not always appropriate. The information l have here may help me to have a useful discussion with staff involved. Thank you.
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