Venous leg ulcers
Quality of life issues for venous leg ulcer patients
Although there is a significant cost and financial burden to the health care provider, there is also a significant cost to the patient. Potentially including psychosocially, emotionally and financially.
Pain can be used as an indicator of the wound type, aetiology and potential bacterial loading of the wound. Hoffman et al (1997) describes pain as the worst part of having a leg ulcer because it is so often underestimated. This may result in poor pain management strategies.
The World Health Organisations three step ladder for the management of pain provides a range of options from non-opioids to opioids.
Pain management must be considered as a significant part of the management plan to reduce the risk of social isolation. Social isolation can be induced by a number of factors. Reduced mobility due to bandage systems which may affect footwear and potentially increasing the risk of falls. Activities that we take for granted e.g. holidays, swimming, playing with children due to one or more symptom of the ulcer, may not be possible. The wound could affect the way we work even causing the loss of employment, this may result anxiety, depression and potential significant financial risk. Quality of life issues could be amplified by the patient who is not compliant with their treatment plan; this could be due to failings at the point of assessment. There is significant need to improve leg ulcer assessment, diagnosis, treatment and care.
Hoffman D et al (1997) Pain in venous leg ulcers, Journal of Wound Care 6; 5, 222-224 6. Moffatt C et al (2007) Leg ulcer management, London Blackwell.
Reference for knowledge articles 2, 3 and 5 is NHS Choices UK website: http://www.nhs.uk/Conditions/Leg-ulcer-venous/Pages/Symptoms.aspx