Abstract

LOPEZ SAN MARTIN, Marina et al. Protocol and algorithm for diagnosis, treatment and early referral of lower limb ulcers. Angiología [online]. 2023, vol.75, n.2, pp.59-66.  Epub May 01, 2023. ISSN 1695-2987.  https://dx.doi.org/10.20960/angiologia.00435.

Venous ulcers are a prevalent disease, especially in elderly patients. They have a negative impact in patients' quality of life and carry a significant economic burden. This article suggests an algorithm for the diagnosis and treatment of lower extremity ulcers in order to optimize their management. There is huge evidence and multiple organizations have published guidelines, consensus documents and treatment recommendations. Nevertheless, there is still a gap between evidence and clinical practice.

Urgo Laboratories proposed the Spanish Phlebology and Lymphology Chapter the creation of a Spanish and Portuguese experts committee the elaboration of an algorithm for diagnosis and treatment and early referral of lower extremity ulcers. A systematic review was performed, considering the current clinical practice guidelines.

The algorithm was designed on a simple alphabetic mnemonic rule aiming to easily memorize the key points and most relevant issues of the diagnosis and treatment of these ulcers.

All necessary steps from primary care nurses and physicians to Vascular Surgery were considered. With the alphabet letters from A to F in Spanish, all key points were summed up. To confirm ulcer diagnosis (asegurar el diagnóstico de la úlcera), best local treatment, compressive therapy, preventive treatment after healing (tratamiento preventivo de recidiva después de la cicatrización de la úlcera), surgical strategy (estrategia quirúrgica) and pharmacological strategy (estrategia farmacológica).

An accurate diagnosis, a clinical practice according to the clinical practice guidelines and an early referral to the specialist in order to determine if there is a surgical or interventional strategy are essential to effective resolution and reduction of ulcer healing time, and finally to prevent its recurrence.

Keywords : Venous leg ulcers; Chronic venous disease; Evidence based practice; Treatment algorithm.

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