Implementation of a leg ulcer strategy.

Area of Science:

• Vascular Medicine
• Wound Care Management
• Health Services Research

Background:

• Leg ulceration care has evolved over 15 years, but its impact on patient outcomes remains under-documented.
• Limited information exists on how changes in leg ulcer management affect clinical and patient-defined outcomes.

Purpose of the Study:

• To describe the implementation process of a comprehensive leg ulcer strategy.
• To evaluate the effectiveness of the new strategy on patient outcomes and resource utilization.

Main Methods:

• A pre- and postimplementation evaluation design was employed within community-based leg ulcer services.
• Key interventions included standardized Doppler ultrasound assessment, multilayer elastic compression therapy, and defined referral criteria.
• Healing rates, health-related quality of life, and healthcare resource use were assessed at 12 weeks.

Main Results:

• Postimplementation, correct assessment (Ankle Brachial Pressure Index) rose to 94% and high compression therapy use to 85%.
• Twelve-week healing rates improved significantly, with overall healing increasing from 14% to 37% (OR=3.53, P<0.001).
• Treatment visit frequency decreased, and significant improvements in quality of life (energy, pain, sleep, mobility) were observed.

Conclusions:

• Rationalizing leg ulcer services via a total service change enhances professional practice and patient outcomes.
• The implemented strategy led to more efficient use of healthcare resources.
• A multifaceted approach tailored to organizational needs is crucial for improving leg ulcer care.