This article outlines a survey that was undertaken in the community to find out how often patients with venous disease who are wearing compression hosiery have their ankle brachial pressure index (ABPI) monitored. It also asked clinical nurse specialists (CNSs) their opinion on the desired frequency of ABPI follow-up, and which patient groups they considered to be most at-risk. The survey findings highlight the lack of consensus and consistency in follow-up care. The majority of CNSs identified potential high-risk patient groups, the majority of which have their ABPI monitored every three months. However, there were inconsistencies in time interval for follow-up in patients with similar risk factors.
Winnie Furlong, Lead Clinical Nurse Specialist, Princess Alexandra Hospital and West Essex Leg Ulcer Service
Literature has shown that patients with leg ulcers can have a significantly poorer quality of life compared to those without leg ulcers. In addition, research has identified problematic relationships between patients with leg ulcers and practitioners, such as community nurses. The author contends that this mismatch needs to be addressed in order to improve patient quality of life through leg ulcer bandaging. He makes several recommendations for practice and highlights that community practitioners need to use innovative practice to help improve the quality of leg ulcer bandaging care they deliver. The overall aim of this article is to establish the extent of community practitioners’ understanding of the impact of leg ulcer bandaging on patient quality of life.
Edwin Tapiwa Chamanga, Tissue Viability Service Lead, Ipswich Hospital NHS Trust
In patients with venous and lymphovenous disease, skin changes to the lower limb(s) occur gradually, and become more serious over time if left untreated. The CHRonic Oedema Signs and Symptoms (CHROSS) Checker is a tool kit consisting of an assessment chart and key cards that have been developed to help clinicians easily identify the skin changes that occur as a result of underlying venous and lymphovenous disease, when carrying out holistic patient assessment. It also provides clear guidance on which compression products can be used to manage the disease type and severity of skin change. For clinicians unfamiliar with some or all of the signs and symptoms listed on the CHROSS Checker chart, the key cards contain further information in the form of a photograph, definition and cause of each sign and symptom listed. This article will describe the theory behind the development of the CHROSS Checker tools and explain how to use them in clinical practice.
Janice Bianchi, Independent Medical Education Specialist and Honorary Lecturer, Glasgow University
Andy Kerr & Sylvie Hampton discuss the use of the Clini Duo40 venous ulcer compression system in treatment and prevention of venous ulceration.
Andy Kerr RN, Dip HE is a Tissue Viability Consultant.
Sylvie Hampton MA, BSc (Hons), DpSN, RGN is a Tissue Viability Consultant. Wound Healing Centre, Eastbourne.
Morag McKenzie discusses the use of compression therapy for a variety of leg ulcers
Morag McKenzie RGN, BSc Community Health Nursing, PG Dip Wound Healing & Tissue Repair is a District Nurse, Ormiston, Lothian Health Board, Scotland,
Article accepted for publication: December 2009
