ABPI reporting and compression recommendations in global clinical practice guidelines on venous leg ulcer management: A scoping review

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below‐knee compression to improve healing outcomes after calculating the ankle‐brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international CPGs for VLU management to determine if consensus existed in relation to recommendations for compression application based on an ABPI reading and clinical assessment. Our review shows that there is a lack of consensus across 13 VLU CPGs and a lack of clear guidance in relation to the specific ABPI range of compression therapy that can be safely applied. An area of uncertainty and disagreement exists in relation to an ABPI between 0.6 and 0.8, with some guidelines advocating that compression is contraindicated and others that there should be reduced compression. This has implications in clinical practice, including when it is safe to apply compression. In addition, the inconsistency in the levels of evidence and the grades of recommendation makes it difficult to compare across various guidelines.
Original languageEnglish
Pages (from-to)406-419
Number of pages14
JournalInternational Wound Journal
Volume16
Issue number2
DOIs
Publication statusPublished - Apr 2019

Keywords

  • ankle-brachial pressure index (ABPI)
  • clinical practice guidelines
  • consistency
  • scoping review
  • venous leg ulcers

Cite this

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title = "ABPI reporting and compression recommendations in global clinical practice guidelines on venous leg ulcer management: A scoping review",
abstract = "Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below‐knee compression to improve healing outcomes after calculating the ankle‐brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international CPGs for VLU management to determine if consensus existed in relation to recommendations for compression application based on an ABPI reading and clinical assessment. Our review shows that there is a lack of consensus across 13 VLU CPGs and a lack of clear guidance in relation to the specific ABPI range of compression therapy that can be safely applied. An area of uncertainty and disagreement exists in relation to an ABPI between 0.6 and 0.8, with some guidelines advocating that compression is contraindicated and others that there should be reduced compression. This has implications in clinical practice, including when it is safe to apply compression. In addition, the inconsistency in the levels of evidence and the grades of recommendation makes it difficult to compare across various guidelines.",
keywords = "ankle-brachial pressure index (ABPI), clinical practice guidelines, consistency, scoping review, venous leg ulcers",
author = "Weller, {Carolina D.} and Victoria Team and Ivory, {John D.} and Kimberley Crawford and Georgina Gethin",
year = "2019",
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doi = "10.1111/iwj.13048",
language = "English",
volume = "16",
pages = "406--419",
journal = "International Wound Journal",
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publisher = "Wiley-Blackwell",
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T1 - ABPI reporting and compression recommendations in global clinical practice guidelines on venous leg ulcer management

T2 - A scoping review

AU - Weller, Carolina D.

AU - Team, Victoria

AU - Ivory, John D.

AU - Crawford, Kimberley

AU - Gethin, Georgina

PY - 2019/4

Y1 - 2019/4

N2 - Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below‐knee compression to improve healing outcomes after calculating the ankle‐brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international CPGs for VLU management to determine if consensus existed in relation to recommendations for compression application based on an ABPI reading and clinical assessment. Our review shows that there is a lack of consensus across 13 VLU CPGs and a lack of clear guidance in relation to the specific ABPI range of compression therapy that can be safely applied. An area of uncertainty and disagreement exists in relation to an ABPI between 0.6 and 0.8, with some guidelines advocating that compression is contraindicated and others that there should be reduced compression. This has implications in clinical practice, including when it is safe to apply compression. In addition, the inconsistency in the levels of evidence and the grades of recommendation makes it difficult to compare across various guidelines.

AB - Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below‐knee compression to improve healing outcomes after calculating the ankle‐brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international CPGs for VLU management to determine if consensus existed in relation to recommendations for compression application based on an ABPI reading and clinical assessment. Our review shows that there is a lack of consensus across 13 VLU CPGs and a lack of clear guidance in relation to the specific ABPI range of compression therapy that can be safely applied. An area of uncertainty and disagreement exists in relation to an ABPI between 0.6 and 0.8, with some guidelines advocating that compression is contraindicated and others that there should be reduced compression. This has implications in clinical practice, including when it is safe to apply compression. In addition, the inconsistency in the levels of evidence and the grades of recommendation makes it difficult to compare across various guidelines.

KW - ankle-brachial pressure index (ABPI)

KW - clinical practice guidelines

KW - consistency

KW - scoping review

KW - venous leg ulcers

U2 - 10.1111/iwj.13048

DO - 10.1111/iwj.13048

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SP - 406

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JO - International Wound Journal

JF - International Wound Journal

SN - 1742-4801

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