Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Background
  • Leg ulcer disease is typically cyclical and chronic, with periods of healing followed by recurrence.
  • Leg ulcers are a major cause of morbidity, suffering and high health service costs. 
  • The negative impact on the sufferer’s quality of life is significant, as individuals may experience mobility loss, chronic pain, fear, anger, depression, and social isolation (Phillips, Stanton, Provan & Lew, 1994; Pieper, Szczepaniak & Templin, 2000; Price & Harding, 1996).
  • A one-month prevalence study in one large Canadian region found a prevalence rate of 1.8 per 1,000 for the population over the age of 25 (Harrison, Graham, Friedberg, Lorimer & Vandervelde-Coke, 2001).
  • The care of this population is compounded by the fact that the condition is highly associated with age, with the prevalence rate reported in the 2 percent range for those over age 65 (Callam et al., 1985; Cornwall et al., 1986).
  • Reports on the percentage of lower limb ulcerations that result predominantly from a venous etiology range from 37 to 62 percent (Baker et al., 1991; Callam et al., 1985; Cornwall et al., 1986; Nelzen, Bergquist, Lindhagen & Halbrook, 1991; Nelzen et al., 1995).
  • Some studies found venous leg ulcers had a longer duration and a higher recurrence rate than those of a non-venous etiology (Baker et al., 1991; Nelzen et al., 1995).
  • Surveys have shown wide variation in the clinical management of leg ulcers. Numerous types of wound dressings, bandages and stocking are used in the treatment and prevention of recurrence (Lees & Lambert, 1992; Stevens, Franks & Harrington, 1997).
  • As the prevalence of leg ulcers increases with age, the swell in the elderly population with the advance of the “boomer” generation, and an anticipated increment in longevity will result in higher resource demand for community leg ulcer care.