Leg ulcers: A cross-sectional survey of management practices and treatment costs in Ireland

Objective: To review the management and the cost of leg ulcers. Design: Cross-sectional survey based on a questionnaire completed by healthcare workers caring for patients with leg ulcers in a defined population. Setting: The Mid-Western Health Board area in Ireland with a population of 317 069. Patients: All patients receiving healthcare for active leg ulceration. Results: Leg ulcers were recorded for 389 individuals and public health nurses primarily provided care (n = 283). Patients had open ulcers for a median period of 8 months (interquartile range: 3 months - 2 years) with almost half (n = 181) reporting previous episodes of ulceration. Fifty different dressing products were used to treat leg ulcers in the region. Only 52.2% (203/389) of patients had the aetiology of their leg ulcers properly investigated and evidence-based care was generally apparent in this group. Otherwise, care appeared haphazard and at times inappropriate. The estimated annual direct cost of dressing leg ulcers was €585 660. Conclusion: A regional strategy for managing leg ulcers needs to be clarified and implemented if practitioners are to incorporate evidence-based care into routine work.