Leg ulcer service provision in NHS hospitals
Leg ulcers are painful, distressing and common in the older population. They are costly to treat and put pressure on NHS providers. Compression therapy is the mainstay of treatment of venous leg ulceration.
To explore the service provision for compression therapy for inpatients with leg ulcers in UK hospitals.
An online survey was carried out to explore the service provision in hospital settings. It was distributed to Wounds UK National Conference delegates and to wound care specialist groups using social media.
The authors received 101 responses from health professionals in the UK. Of these, 67.3% reported there was no dedicated service for inpatients with leg ulceration and only 32% said compression therapy was provided in their hospitals.
This survey confirmed there is a significant shortfall in care provision for patients with leg ulcers in secondary care and highlighted the wide variations in service delivery in hospitals. Further research is needed to understand the reasons for these variations.
A leg ulcer is an open wound between the knee and ankle that remains unhealed for at least 4 weeks (Scottish Intercollegiate Guidelines Network (SIGN), 2010). Leg ulcers are painful, distressing and embarrassing for patients (Anderson et al, 2012). They can cause social isolation, immobility, uncontrolled wound exudate and an unpleasant odour (Vowden et al, 2000; Moffatt, 2004; Dumville et al, 2009). Around 1.5% of the UK population have a leg ulcer and prevalence increases with age (Green et al, 2017). Leg ulcers are very costly to treat and put a strain on healthcare providers (Guest et al, 2017; Gray et al, 2018).
Venous leg ulcers are the most common type (70%) of leg ulcers (Dealey, 1999; Guest et al, 2021). Compression therapy is the mainstay of treatment of venous leg ulceration and promotes healing by reducing oedema and improving venous return (SIGN, 2010; Guest at al, 2018). Compression therapy also helps to prevent ulcer recurrence, which can be as high as 70% (SIGN, 2010; White et al, 2011). While most leg ulcer patients are being cared for in community settings, patients can also be admitted to secondary care because of a complication of ulceration or for a comorbidity where the leg ulcer is not the primary concern.
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