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452 LIFELONG MANAGEMENT
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and then plan and implement their ongoing care in collaboration
with the patient.
Patients need to be supported throughout their leg ulcer management journey and healthcare professionals need to work with
them so that looking after their well legs as this is a lifelong commitment. The choice of hosiery should be that of the patient and the
healthcare professional should be there to guide the patient’s decision about which garments to choose and which would provide the
best clinical outcome for them. If the patient agrees with the prescribed garment and if they have chosen it and accepted its use, there
will be an easier road to well legs in the future.
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454 LIFELONG MANAGEMENT
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Lifelong Management 455
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456 LIFELONG MANAGEMENT
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Index
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Note: Page numbers in italic and bold refers to gures and tables,
respectively.
A
absorbent dressing, 6, 7, 371
Accelerate CIC, 7
Achilles’ tendon, 132, 139
adipose tissue, 51, 64, 87,
88, 142, 203
adjunct treatment modalities:
intermittent pneumatic
compression, 81
Kinesio tape, 80–81
laser therapy, 81–82
manual lymphatic drainage, 79
self‐lymphatic drainage, 80
adverse drug reactions, 155
aetiology, 306
arterial disease, 24–33
blood pressure in veins and
capillaries, 17
chronic venous insuciency,
23–24
lipoedema, 88
Marjolin’s ulcers, 149, 152
Martorell’s ulcers, 141
necrobiosis lipoidica, 134
normal venous function, 11–16
pathophysiology of CVD, 19–20
risk factors for venous
insuciency, 24, 25
skin, 33–35
systemic scleroderma, 124
theories of tissue damage, 21–23
veins in action, 16, 16–17
venous disease, 18–19
wound healing, 35–39
albumin, low serum, 54
alcoholism, 233
allergen groups, 231
allergies, 58, 231–232, 307
allied health professionals (AHP),
206, 211, 218
allodynia, 293
amitriptyline, 114
anaemia, 54, 230
chronic, 131
sickle cell, 130
analgesia, 114, 129, 141
opioid‐based, 145
pain management, 306–308
angina, 230, 362–363, 365
angiogenesis, 38
Lower Limb and Leg Ulcer Assessment and Management, First Edition.
Edited by Aby Mitchell, Georgina Ritchie, and Alison Hopkins.
© 2024 John Wiley & Sons Ltd. Published 2024 by John Wiley & Sons Ltd.
本书版权归John Wiley & Sons Inc.所有
457
458 Index
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ankle brachial pressure index
(ABPI), 384, 405, 443, 448, 451
ankle systolic pressure
measurement, 272, 273
biphasic signal of, 273, 274
brachial systolic pressure
measurement, 269–270
calculation and interpretation
of, 273–276
Doppler reassessment, 276
erosive pustular dermatosis, 164
holistic reassessment, 409–411
indicators for compression
therapy, 275
leg ulceration assessment, 227
lower limb assessment, 110–111
PAD assessment, 265, 266–267
ankle joint, 195–196
assessment, 196–198
ROM, 191
ankle systolic pressure
measurement, 270–273
arterial pulses of foot, 271
lower limb cu position, 272
antalgic gait pattern, 192
anterior tibial artery (ATA),
29, 29, 270
anterior tibial vein, 15
anti‐inammatory action of
compression therapy, 381–384
compression reducing
inammatory response, 383
Laplace’s law explanation, 382
signs of inammation before
ulceration, 383
anti‐seizure drugs, 145
anti‐TNF treatment, 119
anticonvulsants, 114, 307
antidepressants, 114
antimicrobial dressings, 6, 7,
122, 155
antineutrophil cytoplastic antibody
(ANCA), 117
anxiety, 254
arm lymphoedema, 52
artefactual ulcers. See dermatitis
artefacta
arterial blood ow, 193, 265
arterial disease, 24, 248
acute arterial thrombus or
embolism, 32
arterial ulceration, 248
arteries, 26–29
atherosclerosis, 30–32
clinical descriptors of arterial leg
ulcers, 26
identication in lower
limb, 249–251
inammatory vascular
disease, 32–33
modalities for assessing, 265–266
PAOD, 29–30
risk factors for venous and, 33
6Ps of PAD, 252
skin tone tool, 252
arterial duplex scan, 265–266
arterial leg ulceration, 297
arterial thrombus, acute, 32
arteries, 26–29. See also peripheral
arterial disease (PAD)
ATA, 29, 29, 270
deep femoral, 29, 29
dorsalis pedis, 270
elastic, 28
femoral, 29, 29–30
functions in leg, 29
layers of, 27
muscular, 28
peroneal tibial, 270
popliteal, 29, 29
PTA, 29, 29, 270–272
arterioles, 11, 26, 28
atherosclerosis, 30–32, 233, 268
atrial brillation, 32, 270
atrophie blanche, 243, 244, 297
audit process, 444, 446–450
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Index 459
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auto‐immune conditions, 230
autolytic debridement, 154
B
bandaging, 77
bandages, 387
ankle circumference, 389
applying inelastic bandage, 393
management of, 3
tubular stockinette, 390
types of, 392–394
wadding layer, 391
basal cell carcinoma (BCC), 146
diagnosis, 153–154
examination, 150–153
history, 149–150
intervention, 154–155
investigations, 153
key risk factors and presentation
of, 147–148
presenting as leg ulcer, 150
bell‐cord theory, 287
bespoke footwear, 214
bespoke hosiery, 407, 421
big data, 2
biologics, 112, 117
biomechanical lower limb
function, 198
co‐morbidities and medicines, 199
falls history, 200–201
immobility and impaired mobility
history, 198–199
injury history, 200, 200
mechanisms of falling, 201
obesity, 203–204
physical activity, 204–205
sitting and standing
occupations, 202–203
surgical history, 201–202
biopsy/biopsies, 116–117
of active ulcer edge, 110
skin, 121, 127
tissue, 116, 139, 173
biopsychosocial model,
290–292, 291
bipedalism, 205
blood ow:
arterial, 193
through arteries and
arterioles, 11, 12
in arteries and veins, 265
from capillaries to venules, 13
oxygenated, 354
blood pressure:
brachial systolic, 269–270
in veins and capillaries, 17
body language, 301, 302
body mass index (BMI), 57, 232
Bowen’s disease. See squamous cell
carcinoma (SCC)
brachial systolic blood pressure
measurement, 269–270
British Health Professionals in
Rheumatology (BHPR), 129
British Society of Rheumatology
(BSR), 129
British Standard Class 1 hosiery
stockings, 360
British standard hosiery, 416, 417
Buruli ulcers, 175–176, 176
C
calcinosis, 126, 128, 129
calcinosis cutis, 125, 126
calciphylaxis, 141
diagnosis, 144
dusky, mottled skin in early
stages, 143
examination, 142
history, 142
intervention, 144–145
investigations, 143–144
necrotic lesion from, 143
calcium channel blockers, 365
calcium deposits, 125, 126
Candida albicans, 164
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460 Index
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capillaries, 11, 26
blood ow to venules, 13
blood pressure in, 17
glycocalyx and endothelium
changes in, 20
lymphatic, 44
cardiac arrhythmias, 268
cardiac vascular history, 230–231
cardiovascular haemostasis, 27
Care Act (2014), 170
cellulitis, 52, 69, 70, 71, 73, 267
history, 57, 58, 59
lower limb, 48
recurrent, 53, 67
charcoal dressing, 155
chemotherapy, 52, 154, 230, 254
CHORUS study, 229
chronic disease management, 35
chronicity, 383
of CVD, 189
lower limb wounds, 405
of VLUs, 189, 190, 196
chronic obstructive pulmonary
disease (COPD), 230
chronic oedema, 9, 50, 51, 92, 200,
356–366, 412, 417, 420
chronic recurrent disabling
ulcer, 131
chronic venous disease (CVD),
19, 188, 189
chronic venous hypertension, 18–19
chronic venous insuciency (CVI),
18, 23–24, 149, 204, 238
Churg Strauss syndrome, 115
circular‐knit garments, 416–417
Clinical‐Etiology‐Anatomy‐
Pathophysiology (CEAP),
23–24, 238
standard for identifying venous
disease, 239–247
venous disease with, 229
clinical competence, 331
clinical management, 165, 360
exudate management, 369–372
good skincare undergoing
compression therapy, 367, 368
of limb, 366
lower limb management plan, 361
medication management, 362
medications causing leg and foot
ulceration, 362–364
medications causing or
exacerbate swelling, 365–366
medications used to treat venous
ulceration, 364–365
non‐venous ulceration, 365
of person, 360
co‐analgesics, 307
co‐morbidities:
of compression therapy, 385–386
wound healing, 253–254
cohesion, sense of, 331
Commissioning for Quality and
Innovation (CQUIN), 226, 442
community nurses, 8, 48
competent inuence in leg ulcer
practice, 330–332, 331
complex gait analysis, 206
Comprehensive Model for
Personalised Care, 435
comprehensive workforce strategy, 3
compression hosiery, 379, 407
assessment for, 413
British and European standards,
416, 417
choosing and prescribing
hosiery, 415
choosing eective treatment, 418
circular‐knit garments, 416–417
dos and don’ts of, 427–428
at‐knit garments, 417–418
kits, 386–387, 388, 409
limb size and shape, 418
location for leg measurement, 423
made‐to‐measure hosiery, 421
measurement, 422–423
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Index 461
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o‐the‐shelf hosiery, 422
sites to measure limb
circumference, 424
steps for, 414–415
treatments for venous
insuciency and
oedema, 419–420
compression of foot, 396–397
compression therapy, 86, 113, 123,
133–134, 308–309, 376
ABPI indicators for, 275
anti‐inammatory action
of, 381–384
application aids, 429, 430
and assessment, 76–79
cautions and contraindi-
cations, 384
choosing compression therapy
system, 423
co‐morbidities, 385–386
comparison of, 443
considering and commencing
treatment, 386–395
contraindications and cautions
in, 373–374
contraindications for stockings,
garments and hosiery, 425–426
doses of, 370, 377, 378
in EPD, 166
tting and care of hosiery, 426
good skincare undergoing,
367, 368
guide for good medical
compression hosiery t, 426
in healing ulcers, 408
in heart failure, 386
hosiery care, 431
interface pressure, 378–379
knowledge, sta and training,
439–441
Laplace’s law, 380
lifelong compression, 413
for lymphoedema, 78–79
maintaining skin integrity,
431–434
open or closed toe, 425
Pascal’s law, 381
patient education and promoting
self‐care, 429–431
presence of DVT, 385
presence of peripheral arterial
disease, 384–385
stiness index, 379–380
subdivision of venous
pathologies, 375
systems, 411–413
thigh length or knee length, 424
and work principle, 372
compression wraps, adjustable, 409
computed tomography (CT), 154
computer tomography angiogram
(CTA), 266
condent inuence in leg ulcer
practice, 330–332, 331
constipation, 229
constipation, chronic, 25
core capabilities framework:
for personal development for
healthcare practitioners, 441
structure, 440
tiers, 440
for wound care, 439
coronary bypass grafting surgery
(CABG surgery), 201
coronavirus pandemic, 406
corticosteroids, 112, 113, 119
COVID‐19 pandemic, 18, 326, 443
crack cocaine, 157
C‐reactive protein (CRP), 73, 117
cribriform scarring, 109
‘cu’ phenomenon, 91, 91
cutaneous arteritis. See polyarteritis
nodosa cutanea
cutaneous immunoglobulin, 115
cutaneous leishmaniasis,
172, 173, 174
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