ABPI reporting and compression recommendations in global clinical practice guidelines on venous leg ulcer management: A scoping review

Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below ‐knee compression to improve healing outcomes after calculating the ankle‐brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international CPGs for VLU management to determin e if consensus existed in relation to recommendations for compression application based on an ABPI reading and clinical assessment. Our review shows that there is a lack of consensus across 13 VLU CPGs and a lack of clear guidance in relation to the specific ABPI range of compression therapy that ca n be safely applied. An area of uncertainty and disagreement exists in relation to an ABPI between 0.6 and 0.8, with some guidelines advocating that compression is contraindicated and others that there should be reduced compression. This has implications in clinical practice, including when it is sa fe to apply compression. In addition, the inconsistency in the levels of evidence and the grades of recommendation makes it difficult to compare across various guidelines.

Source: International Wound Journal - November 28, 2018 Category: Surgery Authors: Carolina D. Weller, Victoria Team, John D. Ivory, Kimberley Crawford, Georgina Gethin Tags: ORIGINAL ARTICLE Source Type: research