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Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL): Update of the VLU Algorithm

Catherine R Ratliff1,2,3,4, Stephanie Yates1,2,3,4, Laurie McNichol1,2,3,4

  • 1Catherine R. Ratliff, PhD, GNP-BC, CWOCN, CFCN, FAAN, Department of Surgery, UVA Health, Charlottesville, Virginia.

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
|July 9, 2022
PubMed

Insights

The Wound, Ostomy and Continence Nurses (WOCN) Society updated its algorithm for lower extremity venous disease to include lymphedema, creating new clinical guidance for Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL). This involved evidence-based reviews and expert consensus to improve patient care.

Area of Science:

  • Nursing
  • Vascular Medicine
  • Lymphedema Management

Background:

  • Venous leg ulcers (VLUs) are common, often co-occurring with lymphedema.
  • Existing clinical algorithms may not adequately address combined venous and lymphatic disease.
  • The Wound, Ostomy and Continence Nurses (WOCN) Society identified a need for updated guidance.

Purpose of the Study:

  • To update the VLU algorithm to incorporate lymphedema management.
  • To develop consensus-based statements for clinical guidance on Compression for Lower Extremity Venous Disease and Lymphedema (CLEVDAL).
  • To provide evidence-based recommendations for managing patients with co-existing venous and lymphatic disorders in the lower extremities.

Main Methods:

  • A scoping literature review was conducted by a task force to identify evidence-based recommendations.
  • Expert panels were convened to develop and validate consensus statements for CLEVDAL.
  • The process involved two rounds of content validation by clinicians specializing in venous disease and lymphedema.

Main Results:

  • A scoping review identified current evidence and areas needing clinical guidance for CLEVDAL.
  • Consensus statements were generated to direct care for lower extremity venous disease and lymphedema.
  • The developed statements were validated by expert clinicians, ensuring relevance and applicability.

Conclusions:

  • The updated CLEVDAL algorithm provides essential clinical guidance for managing complex lower extremity conditions.
  • Evidence-based and consensus-driven statements support improved decision-making in VLU and lymphedema care.
  • This initiative by the WOCN Society enhances the standard of care for patients with combined venous and lymphatic disorders.

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