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Evidence to Improve Care

Venous Leg Ulcers

Care for Patients in All Settings

Click below to see a list of brief quality statements and scroll down for more information.​​


Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence. ​

See below for the quality statements and click for more detail.​


Quality Statement 1: Screening for Peripheral Arterial Disease
People with a suspected venous leg ulcer are screened for peripheral arterial disease using the ankle-brachial pressure index (ABPI) or an alternative such as the toe-brachial pressure index (TBPI) if ABPI is not possible. Screening is conducted by a trained health care professional during the initial comprehensive assessment and at regular intervals (at least every 12 months) thereafter.


Quality Statement 2: Patient Education and Self-Management
People who have developed or are at risk of developing a venous leg ulcer, and their families or caregivers, are offered education about venous leg ulcers and who to contact for early intervention when needed.


Quality Statement 3: Comprehensive Assessment
People with a venous leg ulcer undergo a comprehensive assessment conducted by a health care professional trained in leg ulcer assessment and treatment, to determine the healing potential of the wound. This assessment informs the individualized care plan.


Quality Statement 4: Individualized Care Plan
People with a venous leg ulcer have a mutually agreed-upon individualized care plan that identifies patient-centred concerns and is reviewed and updated regularly.


Quality Statement 5: Compression Therapy
People who have developed or are at risk of developing a venous leg ulcer are offered compression therapy that is applied by a trained individual based on the results of the assessment and patient-centred goals of care.


Quality Statement 6: Wound Debridement
People with a venous leg ulcer have their wound debrided if it is determined as necessary in their assessment, and if it is not contraindicated. Debridement is carried out by a trained health care professional using an appropriate method.


Quality Statement 7: Local Infection Management
People with a venous leg ulcer and a local infection receive appropriate treatment, including antimicrobial and non-antimicrobial interventions.


Quality Statement 8: Deep/Surrounding Tissue Infection or Systemic Infection Management
People with a venous leg ulcer and a suspected deep/surrounding tissue infection or systemic infection receive urgent assessment (within 24 hours of initiation of care) and systemic antimicrobial treatment.


Quality Statement 9: Wound Moisture Management
People with a venous leg ulcer receive wound care that maintains the appropriate moisture balance or moisture reduction in the wound bed.


Quality Statement 10: Treatment with Pentoxifylline
People with large, slow-healing venous leg ulcers are assessed for appropriateness for pentoxifylline in combination with compression therapy.


Quality Statement 11: Referral to Specialist
People with a venous leg ulcer that is atypical, or that fails to heal and progress within 3 months despite optimal care, are referred to a specialist.


Quality Statement 12: Health Care Provider Training and Education
People who have developed or are at risk of developing a venous leg ulcer receive care from health care providers with training and education in the assessment and treatment of venous leg ulcers.


Quality Statement 13: Transitions in Care
People with a venous leg ulcer who transition between care settings have a team or provider who is accountable for coordination and communication to ensure the effective transfer of information related to their care.

10

Treatment with Pentoxifylline

People with large, slow-healing venous leg ulcers are assessed for appropriateness for pentoxifylline in combination with compression therapy.


Pentoxifylline increases blood circulation and the amount of oxygen delivered by the blood to the muscles. It has been shown to improve the rate of healing for venous leg ulcers, but may take up to 8 weeks to show full results.

For Patients

If you have a leg ulcer that is large or taking a long time to heal, you should be offered a medication called pentoxifylline, which can help heal your leg ulcer. You should talk to your health care professional to see if this medication is right for you. You should continue compression therapy while you take this medication.


For Clinicians

Assess people with large, slow-healing venous leg ulcers for their appropriateness for pentoxifylline treatment, in combination with compression therapy.


For Health Services

Ensure access to pentoxifylline for people with large, slow-healing venous leg ulcers.

Process Indicator

Percentage of people with large, slow-healing venous leg ulcers who are assessed for appropriateness for pentoxifylline treatment in combination with compression therapy

  • Denominator: people with large, slow-healing venous leg ulcers

  • Numerator: number of people in the denominator who are assessed for appropriateness for pentoxifylline treatment in combination with compression therapy

  • Data source: local data collection

Appropriateness for treatment

Some people cannot tolerate this medication, and pentoxifylline is not recommended for people with:

  • Acute myocardial infarction

  • Severe coronary artery disease (where the clinician thinks myocardial stimulation may be harmful)

  • Hemorrhage

  • A history of intolerance to pentoxifylline or other xanthines, such as caffeine, theophylline, and theobromine

  • Peptic ulcers (or a recent history of peptic ulcers)

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