How to measure success in treating chronic leg ulcers

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1434 (Published 17 April 2009) Cite this as: BMJ 2009;338:b1434
  1. Joseph E Grey, consultant physician,
  2. David Leaper, visiting professor,
  3. Keith Harding, professor and head
  1. 1Department of Wound Healing, Cardiff University, Cardiff CF14 4XN
  1. joseph.grey{at}cardiffandvale.wales.nhs.uk

    Healing is not the only desirable outcome measure

    Optimising the care of patients with leg ulcers is problematic not least because of the lack of universally accepted evidence based guidelines.1 Several systematic reviews into the effects of, for example, debridement, compression, topical treatments (including dressings), antimicrobial agents, and newer treatments (such as topical negative pressure devices) have predictably led to the conclusion that more research is needed.2 3 4 5 6 7 In the United Kingdom, clinical guidelines from bodies such as the National Institute for Health and Clinical Excellence (NICE) or the Scottish Intercollegiate Guidelines Network (SIGN) are either not available or have limited value. Three linked studies concern the efficacy and costs of treatments for leg ulcers.8 9 10

    The management of chronic wounds, healing by secondary intention, is challenging—a multidisciplinary approach is generally thought to be the best option.11 12 The importance of developing systems, structures, and appropriate remuneration for caring for patients with such wounds has only recently …

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