LEG ULCER MANAGEMENT

Abstract

This book is written by a group of specialist nurses who have responsibility for an integrated leg ulcer service in Wandsworth, south-west London, UK. The authors share their knowledge and expertise in caring for people with leg ulcers within a model of care that includes community and specialist services. Although the authors describe their experiences in the UK context, there is much that can be learnt by wound clinicians in other countries to improve care of people with leg ulcers. The book has clear clinical advice and algorithmic pathways that serve as useful clinical guides especially in the area of evaluation. The leg ulcer care pathway described by the authors was framed by The International Leg Ulcer Advisory Board which had in 2002 developed a recommended treatment pathway that has been incorporated into the European Wound Management Association’s suite of position statements. A pleasing component of this book is that a whole chapter is devoted to clinical assessment and diagnosis. It is no secret that a definitive diagnosis is the key to successful healing. It will always be much more difficult to treat a ‘leg ulcer’ than it will be to treat a ‘venous leg ulcer’ or an ‘arterial leg ulcer’ simply because as clinicians we need to know what it is that we are treating so we can use best available evidence to guide our practice. The book is divided into five parts. The basics are well covered. Part 1 describes the development of the leg ulcer service model and the leg ulcer care pathway. The model of wound care is well described. Part 2 clinical assessment and diagnosis incorporates a chapter each on venous disease, arterial disease, diabetic leg ulceration as well as other ulcer aetiologies and multifactorial ulceration. Part 3 describes psychological dimensions of assessment and management that covers aspects such as pain, health-related quality of life impact, and the importance of improving concordance. Part 4 highlights the importance of having a multidisciplinary clinical management approach. Part 5 outlines the need to evaluate outcomes. Important aspects such as healing rates, patient satisfaction and prevention of recurrence are covered in detail. The book written in a clear and engaging style aimed at both those who are simply interested in learning more about wound care and those involved in implementing improved wound care. The explanations are generally excellent and as a teacher of wound management to several health disciplines, there are several sections that I plan to use in the future. The book also has many colour photos, illustrations and tables that value add to the clarity of the book. If you want an excellent introduction to overall leg ulcer management then this book is a great start at a reasonable price.