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Multidisciplinary team is the key to rapid and effective management of patient wounds Back to Listings

14 Jul

Mr Jeremy Crane, Consultant Vascular and Transplant Surgeon and one of London Medical Concierge’s network of clinical experts, explains how to tackle a common but serious problem in older age; wounds and leg ulcers

As we age, wounds, including leg ulcers, are a particularly common problem – with up to 10% of people in the UK over 60 suffering from a leg ulcer. The condition is more common in the elderly and those with diabetes, mobility issues, circulatory problems such as varicose veins and obesity. People may need treatment for a range of wounds and ulcers, including pressure sores, leg ulcers, non-healing wounds after surgery, diabetic-related wounds, cancer-related wounds and wounds resulting from falls and accidents.

70% of leg ulcers are venous, which means they’ve been caused when persistently high blood pressure in leg veins results in fluid leaking out, causing swelling and damage to the skin. 

Eventually, the skin breaks down and forms an ulcer, or open wound, typically just above the ankle.

The impact of leaving wounds untreated can be significant. Leg ulcers can be painful if untreated and run the risk of getting infected, which can lead to serious health issues such as severe pain, blood poisoning, gangrene and even amputation.  It can also stop those affected with leg ulcers leaving their house.

What’s the best treatment?

Unfortunately, many people wrongly think that you can treat a wound at home with common over-the-counter treatments and traditional remedies such as antiseptic cream, cold cream and “ordinary” bandages or plasters. In addition, some patients are failing to receive the right treatment for leg ulcers, as they are not being seen initially by the right medical professional – a vascular surgeon. As a result, patients visiting our clinic have often lived with untreated wounds for 3-4 years, which could have been successfully treated in 6 weeks.

The most important step to successful treatment is to see a wound care specialist, ideally in a multidisciplinary clinic. This means that both a Consultant Vascular Surgeon and a Consultant Tissue Viability Nurse will see you at the same time in the one consultation. Following a series of simple tests and a review of a patient’s medical history, the medical team should be able to tell quickly what is causing the leg ulcers and how to treat them. These combined clinics are recognised as best practice, with a thorough investigation leading to the correct diagnosis and treatment that give excellent results and outcomes.   

What are the latest treatments?

Techniques to aid diagnosis are increasingly sophisticated and non-invasive – for example, the use of colour duplex ultrasound scan, which looks at leg arteries and veins using an ultrasound probe to measure blood flow.  Treatments are also progressing, with a variety of high standard dressings now available to aid quick healing of wounds and ulcers. 

Is there anything I can do to help prevent ulcers?

Rehabilitation post treatment is very important to recovery and prevention of further problems.   For example, patients should be encouraged to keep physically active to increase strength and mobility, as well as enhancing wound healing. People most at risk of developing a venous leg ulcer are those who have previously had a leg ulcer. You can help reduce your risk of further problems in several ways, such as by wearing a compression stocking (to improve circulation), losing weight and taking care of your skin.

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