Primary and secondary prevention in lower leg wounds

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Primary and secondary prevention in lower leg wounds

Supported by L&R
Jacqui Fletcher, Leanne Atkin, Gill Boast, Debbie Brown, Barbara Conway, Rebecca Corneck, Daphne Hazell, Lindsay Rose
13 September 2024
We know that the numbers of patients affected by lower limb wounds and ulceration are staggeringly high (Guest et al, 2020). While care has long reflected the evidence that healing patients quickly is of paramount importance, there is a need for a change of mindset that focuses on prevention rather than management.

Care should start with a focus on risk assessment and identifying those who are at risk of developing a wound – as opposed to managing a wound that has developed (Fletcher, 2022). Where primary prevention is not possible, early intervention is key.

An example of best practice is the model of risk assessment for pressure ulcers (PUs), which provides a useful illustration of the importance of focusing on prevention. Prevalence data over recent decades shows that almost 20% of hospital inpatients (1 in 5) had PUs in the 1990s (O’Dea, 1995), which has now significantly reduced to around 8–9%, so fewer than 1 in 10 patients (Smith et al, 2016; Stephenson et al, 2021).

In October 2023, a multidisciplinary group of experts met to develop this Best Practice Statement on prevention and early intervention in lower limb wounds. The expert group discussed strategies for primary and secondary prevention of lower limb wounds, changing mindsets and improving patient quality of life. 

This Best Practice Statement aims to:

  • Identify and acknowledge gaps within current protocols for preventing venous leg ulcers (VLUs) and lower limb wounds
  • Provide a rigorous and active strategy for both primary and secondary prevention of VLUs
  • Promote change and extend mindsets to encompass not just healing but also primary and secondary prevention.

The ultimate aim is to provide all clinicians with the tools to identify individuals at risk of developing lower limb wounds, and to prevent – or minimise – the risk of patient harm.

Jacqui Fletcher (Chair)

Disclaimer: This document has been developed by Wounds UK and is supported by an unrestricted educational grant from L&R Medical.
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