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Venous Leg Ulcers in the UK: The Local Burden of Illness and the Allocation of Resources

TLDR
A review of the literature was undertaken to assess the prevalence and costs of VLU and the estimated prevalence reported is in keeping with those calculated by SIGN (2010) but less than those reported by Guest et al (2016).
Abstract
The precise UK prevalence of venous leg ulcers (VLU) is currently unclear. Prevalence data is essential in order to calculate the costs and, to measure the impact of any therapeutic intervention. A review of the literature was undertaken to assess the prevalence and costs of VLU in order to collate available data for baseline, or comparative purposes. Thereafter, information on compression bandaging products obtained from the QuintilesIMS database, prescribed for one large city was collected and calculations made to estimate known prevalence in that geographic locality. Results from the literature search showed the prevalence to vary from 0.1 to 1.1 in the studies identified. The prevalence of leg ulcers (LUs) in compression in the city reviewed was calculated to be 0.1 in 2015. There is a lack of reliable information on the prevalence and cost of LUs. The estimated prevalence reported is in keeping with those calculated by SIGN (2010) but less than those reported by Guest et al (2016). The annual cost of treating patients with LUs in the UK has recently been reported to be £1,938 million (Guest et al, 2016). Traditionally, regional clinical commissioning groups (CCGs) and local health authorities have not requested prevalence and outcome data on LUs and, therefore, there is a gap in understanding the extent of the problem. Consequently, the budgeting of services by CCGs is based more on estimates than on prevalence data. Without more accurate prevalence data it is impossible to truly understand the scale of the problem and develop a plan on how best to move forward with improving LU care.

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Citations
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Rationale for participation in venous leg ulcer clinical research: Patient interview study

TL;DR: Four key themes of patients who participated in the Aspirin in Venous Leg Ulcer cohort study identified became basic elements for the Rationale for Research Participation Framework that was developed to improve the participant recruitment process for clinical trials in wound care.
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Study protocol: a pilot clinical trial of topical glyceryl trinitrate for chronic venous leg ulcer healing

TL;DR: A pilot double-blinded randomised controlled clinical trial is undertaken to provide proof of concept of a novel treatment, topical GTN, which may accelerate wound healing through improvements to vasodilation and antimicrobial properties at the wound bed.
References
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Journal ArticleDOI

Chronic ulceration of the leg: extent of the problem and provision of care.

TL;DR: A postal survey in two health board areas in Scotland, encompassing a population of about one million, identified 1477 patients with chronic ulcers of the leg, where the median age of the women was 74 and of the men 67.
Reference EntryDOI

Compression for preventing recurrence of venous ulcers

TL;DR: Not wearing compression was associated with recurrence in both studies identified in this review, circumstantial evidence of the benefit of compression in reducing recurrence and patients should be offered the strongest compression with which they can comply.
Journal Article

The burden of chronic wounds in the UK.

TL;DR: The costs of chronic wound management and the impact on patients and the healthcare system are discussed.
Journal ArticleDOI

Health economic burden that different wound types impose on the UK's National Health Service.

TL;DR: Clinical and economic benefits to both patients and the NHS could accrue from strategies that focus on (a) wound prevention, (b) accurate diagnosis and (c) improving wound‐healing rates.
Journal ArticleDOI

Venous and non-venous leg ulcers : clinical history and appearance in a population study

TL;DR: To increase the accuracy of diagnosis of venous ulcer, clinical examination should be combined with non‐invasive ‘objective’ haemodynamic assessment of the venous circulation.
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