Tower Hamlets lower limb guidelines

These best practice guidelines for assessment and management of non-ischaemic lower leg ulcers or wounds are provided so that current best practice in care can be implemented to change the outcomes and quality of life of the patient.

Guidelines need to identify what good practice looks like. This document describes best practice for those with non-ischaemic wounds, thereby identifying and excluding those with significant arterial ulceration. The risk for this group must be appropriately managed and the correct referral pathway utilised.

Critically, the use of compression therapy for this group needs to be optimised because “under-usage of compression therapy represents lost opportunities for healing wounds and improving patients’ quality of life.

(Harding et al, 2015)

Good wound management guidelines allow the utilisation of check lists so that a process can be thought through and conclusions sought. Inconsistent care or where best practice and education is not used has consequences – it will mean that patient’s wounds will fail to heal, leading to a painful or distressing experience and resources are poorly used. Sadly this also simply means a greater nursing burden than is necessary.

Guidelines do not aim to replace a nurse or doctors clinical judgement but to guide and provide support.

Guidelines can help to provide standardised care for the majority of clients, but there will be some patients who do not fit into a standardised regime. Thus this non-standard group, or those who are not responding to
standard care need to be identified.

Download these guidelines