Venous leg ulcer management in general practice- practice nurses and evidence based guidelines

Background Venous leg ulcers represent the most common chronic wound problem seen in general practice and are commonly managed by practice nurses. Compression therapy has been shown to improve healing. Methods We explored current practice nurse management of venous leg ulcers to determine if evidence based guidelines were used to aid management. A cross-sectional survey in a metropolitan general practice network was used. Results The majority of practice nurses reported that they do not routinely use, or have confidence in using, a Doppler to measure ankle brachial pressure index before compression application and are not responsible for application of compression therapy. Most common referrals are to wound clinics or vascular surgeons. Barriers to referral include access to services and cost of compression bandages. Conclusion Our study highlights that practice nurse knowledge of venous leg ulcer management is suboptimal and that current practice does not comply with evidence based management guidelines.