title: [Leg ulcers: Should general practitioners hospitalize their patients?].
abstract: OBJECTIVE
  Determine whether general practitioners have sufficient expertise in the field of leg ulcers.
  
  
  METHODS
  A cross-sectional survey was conducted among 179 general practitioners working in the region Île-de-France to evaluate the implementation of leg ulcer guidelines issued by the Superior Health Authority (HAS) in 2006. Participating physicians were either internship supervisors or practitioners in Paris' 14th district.
  
  
  RESULTS
  The first hundred usable answers (response rate 65%) came from 71 internship supervisors and 29 practitioners of Paris' 14th district. Only 40% of the physicians were aware of the guidelines, with no significant difference noted between the two groups. 9/10 practitioners examined less than 10 patients with leg ulcers per year. Physical examinations were done according to the guidelines and a venous Doppler was prescribed in two thirds of the cases. The ankle-brachial pressure index (ABPI) essential to diagnose lower limb arteriopathy was measured for only 10% of the patients. In accordance with the guidelines, compression was by far (73%) considered as the main treatment as compared to dressing (37%), but compression therapy was well prescribed in only one-third of the cases. Despite poor prognosis criteria (characteristic and time course), referral for a specialized opinion was rare.
  
  
  CONCLUSIONS
  Even if they were not always aware of the detailed guidelines, the practitioners applied the main recommendations. Nevertheless, practices could be improved by measuring the ABPI, searching for a diagnosis of arteriopathy, and better prescription of compression therapy. General practitioners should refer patients with leg ulcers to a specialized hospital unit.
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France. Electronic address: danasfeir@hotmail.fr.
authors.forename: D
authors.initials: D
authors.lastname: Sfeir
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: I
authors.initials: I
authors.lastname: Lazareth
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: A
authors.initials: A
authors.lastname: Stansal
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: P
authors.initials: P
authors.lastname: Ghaffari
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: U
authors.initials: U
authors.lastname: Michon Pasturel
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonhomme
authors.affiliation: Service de médecine vasculaire, institut de la cicatrisation Jean-Paul-Belmondo, groupe hospitalier Paris-Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors.forename: P
authors.initials: P
authors.lastname: Priollet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D007871:Leg Ulcer / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010297:Paris; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016038:Skin Transplantation / Q000706:statistics & numerical data; D053828:Stockings, Compression; D011795:Surveys and Questionnaires; D018608:Ultrasonography, Doppler / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents
keywords: Ankle-brachial pressure index; Cicatrisation; Clinical practice guidelines; Compression therapy; Contention veineuse; Healing; Hospital expertise; Index de pression systolique; Leg ulcer; Médecine générale; Primary medicine; Recommandations pour la pratique clinique; Ulcère de jambe