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This case series evaluation assessed the efficacy of WoundExpress™ (Huntleigh Healthcare), a novel IPC device, which applies compression to the thigh of the afflicted leg for the management of hard-to-heal leg ulcers. Eleven wound treatment centres or wound care specialists undertook WoundExpress evaluations. Eligible and willing patients (n=61), with a ‘hard-to heal’ leg ulcer used the WoundExpress device for two hours a day, in addition to continuing to receive their standard wound care for a 16-week period. Fifty-three participants completed the evaluations. Thirty-three percent (n=19) of all ulcers healed within the 16-week study period; the mean time to healing was 10 weeks. A further 60% of ulcers (n=35) progressed towards healing within the 16-week period, with a mean surface area reduction of 56% (23cm2). The evaluation concluded that thigh-administered IPC is an effective adjunctive treatment, that aids healing and reduces pain, for patients with hard to heal leg ulcers.

In each issue we investigate a hot topic currently affecting you and your community practice.

A chronic leg ulcer is defined as a defect in the skin below the knee that has persisted for more than two weeks and shows no sign of healing after three or more months (NHS, 2019). Lower limb and leg ulcer management presents a number of global health challenges in terms of nursing resources, wound care dressings and high recurrence rates. Also, the persistence and recurrence of lower limb conditions can lead to physical and emotional distress for individuals and their families, contributing to depression, lack of esteem, self-neglect, social isolation and loss of income.

The nutritional consequences of Covid-19 are not yet fully understood, but knowledge from acute respiratory distress syndrome (ARDS) suggests that patients are likely to experience skeletal muscle dysfunction, which can persist for weeks to years (Files et al, 2015) and impede return to pre-illness status. Many of the signs and symptoms noted to frequently persist after acute Covid infection, such as breathlessness, fatigue, loss of smell and taste and inflammation, can impact oral intake and potentially worsen nutritional status (Arnold et al, 2020; Carfi et al, 2020; Doykov et al, 2020; Mandal et al, 2020; Sudre et al, 2020).