Wound Diagnostics Masterclass 2010, UK

Wounds International hosted a Wound Diagnostics masterclass chaired by Keith Harding and Douglas Queen, in Manchester UK on June 30. Dr Jon Evans presented on vascular assessment methodologies. He has authored 11 papers and presented 22 papers at conferences on new techniques in vascular assessment. Here follows his abstract:
"Under the current UK and European wound care guidelines, the measurement of ABI is seen as an essential part of leg ulcer assessment prior t the applying compression bandaging. The ABI technique is the most effective, accurate and practical method for detecting the presence of arterial disease in an ulcerated limb.
If the patient has calcified arteries then the ABI can provide false readings. In these cases, undertaking toe pressures and TBPI is now becoming the most popular and practical alternative measurement technique. The recording of Doppler waveforms also provides additional information to confirm the clinical findings and ABI results.
The measurement of ABI and TBPI only provides information about the presence of arterial insufficiency to allow treatment of a venous ulcer, and does not provide information on the presence of true venous disease
Various guidelines and recommendations now suggest that a venous assessment should be performed if the ulcer is recurrent or non-healing. This assessment can take the form of photoplethysmography, Doppler or full Duplex ultrasound scans, depending on availability of equipment and resources. The two former techniques can be performed in a primary care setting providing information about the location and severity of the venous disease. This helps the clinician in choosing the appropriate treatment options.
Clinical pathways should now include the assessment of arterial and venous insufficiency as part of a holistic approach to leg ulcer assessment."