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Enabling chronic wounds to heal: management of leg ulcers

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Many leg ulcers fail to heal because of inadequate assessment and treatment choices

Each year community nurses care for 730 000 people with leg ulcers however 284,700 of these leg ulcers will not have healed within a year.1 This article looks at how nurses can increase healing rates in chronic leg ulcers.

Chronic wounds are defined as wounds that fail to proceed through the normal phases of wound healing in an orderly and timely manner.2 A wound is generally considered chronic if it has failed to heal within 4-6 weeks. Chronic leg ulcers are defined as open lesions between the knee and the ankle that have not healed within 4-6 weeks. Most (around 70%) of leg ulcers occur because of venous insufficiency, arterial ulcers account for about 25% of leg ulcers and around 5% of leg ulcers have both venous and arterial components and are referred to as ulcers of mixed aetiology.3

A chronic venous leg ulcer is ‘an open lesion between the knee and the ankle joint that remains unhealed for at least four weeks and occurs in the presence of venous disease.4

Guest and colleagues review of wounds in primary care found that community nurses care for 1.45 million people with wounds each year. Around 47% of wounds are acute wounds and 53% are chronic wounds. Leg ulcers account for 28% of the community nurses wound care caseload however just over half of all leg ulcers do not have a specified diagnosis.1

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