Validation of venous leg ulcer guidelines in the United States and United Kingdom.
BACKGROUND
Venous leg ulcers account for 85% of all lower-extremity ulcers, with treatment costs of 3 billion dollars and loss of 2 million workdays per year. The purpose of this study was to validate the clinical efficacy and cost effectiveness of multidisciplinary guidelines for the diagnosis and treatment of venous leg ulcers.


METHODS
Eighty (40 retrospective, 40 prospective) patients from the United States and United Kingdom were enrolled.


RESULTS
United States patients were 6.5 times and United Kingdom 2 times more likely to heal if a guideline was followed (P <0.001). A significant decrease was noted in healing time for both the United States and United Kingdom (P <0.01), and the median cost decreased significantly when the guideline was followed (P <0.01).


CONCLUSIONS
Implementation of a guideline for diagnosis and treatment of venous leg ulcers resulted in improvement in diagnosis, decrease in healing time, and an increase in healing rates resulting in lower costs.
McGuckin
Maryanne
M
School of Medicine, University of Pennsylvania, 422 Curie Blvd., Rm. 605A, Stellar Chance Building, Philadelphia, PA 19104-6021, USA. mcguckin@mail.med.upenn.edu
Waterman
Richard
R
Brooks
Jill
J
Cherry
George
G
Porten
Lois
L
Hurley
Sharon
S
Kerstein
Morris D
MD
D000368:Aged; D000465:Algorithms; D005260:Female; D019983:Guideline Adherence; D006701:Home Nursing; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis* / Q000451:nursing / Q000628:therapy*; D008297:Male; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011787:Quality of Health Care; D012189:Retrospective Studies; D006113:United Kingdom; D014481:United States; D014945:Wound Healing