Chronic wounds represent a growing medical and economic problem worldwide. Ulcers of lower legs represent a social problem from the affected patients’ perspective, as well as from the cost perspective of the national health insurance for treating and preventing the disease. (Apollonio et al., 2014)
Certainly, there is a great need to prevent the growth of chronic wounds. They present an increasing issue due to the aging of the population in the developed world. The national health care systems will have to actively work towards minimizing the number of new victims and efficiently helping the ones already suffering from chronic ulcers.
There are three simple steps toward correct wound assessment. The quickest and easiest possible way to decide on the best management of various types of leg ulcers is measuring the Ankle-Brachial Index (ABI).
Venous ulcers are treated with compression therapy. Before any compression therapy is assigned, the clinician should determine the level of compression to be safely applied on the leg. For that, the ABI result (ABI 0.8 – 1.20 and above) is key, not only from the wound assessment perspective but also from the legal point of view.
Mixed ulcers are defined with ABI between 0.79 and 0.51, which means they can be treated with compression therapy, but with reduced pressure because there is also a risk of PAD.
Patients with arterial ulcers have ABI under 0.5, which means they most likely have PAD. Arterial ulcers cannot be treated with compression therapy. Their healing potential can be greatly improved if they are properly diagnosed and the medical staff educates the patients on maximizing the perfusion in the legs, which is impaired due to PAD.
ABI measurement is one of the most important steps in the chronic wound assessment. Different associations across the globe are working on raising awareness and the importance of correct wound assessment.
Because of the speed, easiness, and accuracy of our MESI ABPI MD, our presence and recognition are proving to be very meaningful in every compression therapy and wound care management practice.
Ankle Brachial Index. (2012). Journal of Wound, Ostomy and Continence Nursing, 39, pp.S21-S29.
Apollonio, A., Antignani, P., Di Salvo, M., Failla, G., Guarnera, G., Mosti, G. and Ricci, E. (2014). A large Italian observational multicentre study on vascular ulcers of the lower limbs (Studio Ulcere Vascolari). International Wound Journal, 13(1), pp.27-34.
Worldwidewounds.com. (2017). Doppler assessment and ABPI: Interpretation in the management of leg ulceration. [online] Available at: http://www.worldwidewounds.com/2001/march/Vowden/Doppler-assessment-and-ABPI.html [Accessed 15 Apr. 2017].