Dressings and moisture balance

moist (optimal healing)

dry moderately exuding

heavily exuding

Hydrogels Hydrocolloids

Foams Alginates Aquacel

Margi Moncrieff Nurse Practitioner FMC

Venous ulcers and assessment

Although the ulcer may appear venous, the assessment process is

aimed at eliminating an arterial component, so that safe and

effective treatment can be offered. If an arterial pathology is detected,

then a referral to the vascular surgeon is required.

Doppler (ABPI) Lie the patient flat for at least 10 minutes Apply appropriate size cuff around upper

arm; locate brachial pulse; apply gel and

hold Doppler probe at angle of 450:inflate until pulse disappears, deflate and record the point at which the pulse returns; = brachial systolic reading

Repeat on the other arm and record the highest reading of the two, to calculate ABPI

Doppler (ABPI) continued Place cuff around ankle, above malleoli (any

higher up the leg can give a higher reading) Locate DP; apply gel; hold Doppler probe at

angle of 450 :inflate until pulse disappears, deflate and record the point at which the pulse returns; repeat for PT; Record the highest pressure

Repeat process for other foot: Record the highest pressure

Divide the highest ankle pressure by the highest brachial pressure to give your ABPI

Ankle Brachial Pressure Index 1 – 1.2….Normal0.9……….Mild arterial effect (safe to compress)< 0.7 …..Significant arterial disease< 0.6…….Severe PVD>1.3………Refer to vascular specialist

> 1.3; If the arteries of the leg are calcified or hardened, they may fail to occlude even at high pressure. The systolic ankle pressure may then

appear higher, and a false high reading recorded. Other conditions giving higher readings are renal

disease and gross oedema