Lower Limb and Leg Ulcer Assessment and Management

Cover
Title Page
Copyright Page
Dedication Page
Contents
List of Contributors
Foreword
Preface
Acknowledgements
Introduction
	Alison Hopkins and Joseph Montgomery The Wound Care Burden
	The Cost of Sub-Optimal Wound Care
	Classification of Dressing Products
	Dressing Product Analysis
	Online Non Prescription Services
	Conclusion
	References
CHAPTER 1 Aetiology
	Aby Mitchell Normal Venous Function
	Veins in Action
	Blood Pressure in Veins and Capillaries
	Venous Disease
	Pathophysiology of Chronic Venous Disease
	Theories of Tissue Damage
	Chronic Venous Insufficiency
	Risk Factors for Venous Insufficiency
	Arterial Disease
	The Skin
	Wound Healing
	Phases of Wound Healing
	Conclusion
	References
CHAPTER 2 Lymphoedema and Chronic Swelling
	Caitriona O’Neill and Rhodri Harris Function of the Lymphatic System
	Prevalence and Key Facts
	Causes of and Risk Factors
	Assessment, Diagnosis and Staging
	Management Challenges
	Lymphovenous Disease
	Treatment
	Compression Therapy and Assessment Considerations
	Adjunct Treatment Modalities
	Surgery
	Palliative Care
	Lipoedema
	Summary
	References
CHAPTER 3 Atypical Causes of Leg Ulceration
	Sarah Bradbury and Kirsten Mahoney Inflammatory/Autoimmune Disorders
	Metabolic Disorders
	Malignant/Neoplastic Wounds
	Drug-Induced Leg Ulcers
	Erosive Pustular Dermatosis
	Infective Conditions
	Conclusion
	References
CHAPTER 4 Musculoskeletal Factors in Leg Ulcers: Assessment and Management
	Rona Frances Campbell Risk Factors
	Lower Limb Veno-Muscular Pumps
	Ankle Joint Assessment
	Holistic History Taking Relating to Factors that Influence Biomechanical Lower Limb Function
	Management
	Reducing Falls Risk
	Allied Health Professionals as Part of the Multidisciplinary Team
	Conclusion
	References
CHAPTER 5 Assessment of Leg Ulceration
	Karen Staines and Aby Mitchell Assessment
	History Taking
	Examination
	Arterial Disease
	Wound Assessment
	Skin Assessment
	Diagnostic Assessment
	How to Perform a Handheld Doppler
	Red Flags for the Urgent Treatment of Patients with Venous Leg Ulcers
	Reassessment and Recurrence
	Conclusion
	References
CHAPTER 6 Holistic Management of Pain
	Fran Worboys and Alison Hopkins The Pain Experience
	Theories of Pain
	Causes of Pain
	Types of Pain
	Pain Cycles: Never-Ending Pain
	Impact of Pain on People’s Lives
	Causes of Pain
	Pain Management Solutions: Assessment
	Managing Pain
	Conclusion
	References
CHAPTER 7 Personalised Care in Leg Ulceration
	Alison Hopkins and Charlotte Smith The Wider or Social Determinants of Health
	Wider Determinants of Engagement with Treatment
	Making Effective Change
	What Influences Practitioners’ Decision-Making in Leg Ulcer Management?
	The influence of Confidence, Courage and Competence
	A Problematic Culture Within Leg Ulcer Management
	Challenging Non-compliance
	Understanding the Lived Experience
	Support Personal Health Management Through Patient Activation
	Patient Activation Measure
	Shared Decision-Making
	Social Prescribing
	Motivational Interviewing
	Supporting Self-Management
	Legs Matter Coalition: Raising Awareness of Lower Limb Conditions
	Peer Support Groups
	Using Positive Language to Promote a Positive Culture
	Conclusion
	References
CHAPTER 8 Clinical Management of the Lower Limb
	Georgina Ritchie The Case for Early Intervention
	Clinical Management
	What Is Compression Therapy and How Does it Work?
	Anti-inflammatory Action of Compression Therapy
	Cautions and Contraindications
	Considering and Commencing Treatment
	Location of the Ulceration
	Compression of the Foot
	Intermittent Pneumatic Compression
	Wound Bed Preparation and Clinical Management
	Conclusion
	References
CHAPTER 9 Lifelong Management
	Jane Harry Factors Influencing Venous Ulcer Recurrence
	Holistic Reassessment Including Ankle Brachial Pressure Index
	Endovenous Ablation
	Compression Therapy Systems
	Assessing for Compression Hosiery
	Choosing and Prescribing Hosiery
	Other Considerations when Choosing a Compression Therapy System
	Empowering Patients’ Self-Management for Leg Ulcer Prevention
	Knowledge, Staff and Training
	Public Health
	Patient Satisfaction and Quality of Life
	Leg Ulcer Pathways
	Conclusion
	References
Index
EULA