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Ineffective treatment leaves patients with leg ulcers suffering – and the NHS footing the bill

7th January 2019 Print

Throughout the UK, an estimated 500,000 adults experience leg ulcers which require treatment. A leg ulcer is often the result of venous diseases, such as varicose veins, that legs a gaping wound that is both painful and difficult to mend without intervention. Of the half-million patients who visit the NHS for assistance with leg ulcers, the majority are given an outdated treatment plan that includes the use of compression bandages. A recent study reveals that while compression bandaging can be beneficial for a small portion of the patient population, many continue to suffer with leg ulcers when this is the only treatment recommended. 

The Cost of Ineffective Treatments

The NHS’ go-to treatment suggestion for adults with leg ulcers is short-term at best. Since compression bandaging is meant to release some of the pressure placed on the veins, it does not necessarily address the underlying issue of venous disease that may be causing the ulcer in the first place. Wearing constant dressing and compression bandages may help with the pain felt by patients, but the treatment lacks the ability to cure what led to the ulcer in the first place. However, the NHS continues to suggest compression bandages for leg ulcer patients, at a cost of £2 to £3 billion each year. 

Because the use of compression bandages on leg ulcer is not in and of itself an effective approach to treatment, patients are taking their dissatisfaction to the courts. Having no alternatives to bandaging for leg ulcers has meant unpleasant experiences for hundreds to thousands of individuals visiting the NHS, leaving them with continued pain, the possibility of infection, and little hope for the future. Patients who have not received the best available treatment are taking legal action to argue that better alternatives exist, some of which may have worked to cure the leg ulcer instead of masking it with compression bandages for an extended period. 

Alternatives to Compression 

Eddie Chaloner, a vascular surgeon at a leading vein clinic in the UK, explains that while compression bandaging was a viable treatment option for leg ulcers in the past, the option is now outdated. Many patients who experience leg ulcers due to venous disease could be offered an out-patient procedure known as endovenous laser therapy, or EVLT. As a minimally-invasive approach to treating the issues that cause leg ulcers, EVLT is a more appropriate option for many patients. The less than an hour-long treatment utilises laser heat to seal off broken veins, which over time, are absorbed by the body. This promotes the healthy veins in the affected area to work properly. 

EVLT is a procedure available to only a handful of patients throughout the NHS, for a variety of reasons. Many providers are untrained in the benefits and execution of the treatment procedure, and so it is not made available to the masses. The NHS, then, is more focused on offering temporary solutions to those who present with leg ulcers, but the cost of doing so is becoming more of a burden than a benefit. Individuals who do not see any improvement with compression bandaging are often back at the NHS with unhealed ulcers or other complications that can be more costly to treat. These individuals are also left in pain for longer than necessary, when EVLT could have been a realistic solution in the first place. 

The NHS las long struggled with budgetary woes and short-staffing, neither of which are solved by the continued use of compression bandaging for leg ulcer patients. The health system could benefit immensely by transitioning treatment of leg ulcers to EVLT for patients who qualify for the procedure, using available resources to train providers on the procedure and its benefits. However, until that shift takes place, hundreds of thousands of patients may continue to suffer from leg ulcers that fail to heal because of outdated compression bandage treatment recommendations.

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