Evaluation of the quality of venous leg ulcer care given in a multidisciplinary specialist centre.
OBJECTIVE
To determine the quality of venous leg ulcer care given in a multidisciplinary, specialist wound-healing centre and to identify problem areas that might affect it.


METHODS
The case records of 90 consecutive patients with venous leg ulcers, diagnosed and treated at the Copenhagen Wound Healing Centre, Denmark, were retrospectively audited by a Scandinavian cross-sectional and multidisciplinary expert panel. Quality of care was audited in each case using implicit criteria. The experts then formulated key recommendations for good clinical practice for patients with venous leg ulcers.


RESULTS
Quality of care was satisfactory in 74 patients (82%). The one-year healing rate was 77% (69/90), with a three-month recurrence rate of 12% (11/90). Identified problem areas included the lack of systematic assessment of patients' suitability for surgery; lack of systematic, duplex-verified diagnoses of venous aetiology; and the lack of systematic examination of distal arterial pressure. The recommendations include the need for venous diagnosis, differential diagnosis, compression therapy, surgery, systemic treatment, access to venous leg ulcer care and better communication.


CONCLUSIONS
The quality of venous leg ulcer care given in this multidisciplinary centre was satisfactory.
Kjaer
M L
ML
Copenhagen Wound Healing Center, H:S Bispebjerg Hospital, University of Copenhagen, Denmark. m.kjaer@dadlnet.dk
Sorensen
L T
LT
Karlsmark
T
T
Mainz
J
J
Gottrup
F
F
D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards*; D003718:Denmark; D006801:Humans; D008485:Medical Audit; D010348:Patient Care Team / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012189:Retrospective Studies; D014647:Varicose Ulcer / Q000175:diagnosis / Q000628:therapy*; D014945:Wound Healing