Improving the Diagnosis of Chronic Leg Ulcers: A One-Stop Vascular Assessment Clinic in a Community Service

Objective:

To evaluate the influence of a specialized vascular-led community leg ulcer service on assessment and diagnosis of leg ulcers.

Design:

Before-and-after study with prospective and retrospective data collection.

Setting:

East Gloucestershire, England, UK.

Subjects:

Patients treated for chronic leg ulcers before and within a specialized service incorporating a one-stop assessment including ankle–brachial pressure index (ABPI) and colour venous duplex.

Main outcome measures:

The means of assessment and the identified aetiology of leg ulcers in community patients.

Results:

Before clinics, only 40 (26%) limbs had a diagnosis recorded. After clinics, 83 (21%) limbs had arterial disease, including 64 (16%) with mixed arterial/venous disease. Venous duplex identified 279 (70%) limbs with venous disease of which 121 (43%) had superficial venous disease alone.

Conclusion:

A one-stop assessment clinic with ABPI and colour venous duplex ultrasound within a specialized community service improves diagnosis of leg ulcers. This is essential before appropriate and safe management by specialist nurses in the community.