Venous Leg Ulcer and the calf-muscle pump
Venous leg ulceration is defined as “an area of discontinuity of the epidermis and the dermis on the lower leg persisting for at least four weeks”. There are several aetiologies of leg ulcers but the most common are, chronic venous hypertension and peripheral arterial occlusive disease (Duff et al., 1999).
Patients with venous leg ulcers have a dysfunction of the calf muscle pump (CMP) which is the main mechanism by which blood returns to the heart from the lower limbs. A defective CMP results in reduced ankle range of motion (ROM) and calf muscle activity which are the two main components of CMP (Orr et al., 2017). Araki et al., (1994) demonstrated the role of the CMP in the pathogenesis of venous ulcer. Several studies have also demonstrated that, a defective CMP and poor ankle ROM are associated with prolonged healing of leg ulcers (O’Brien et al., …show more content…
This includes but not limited to, the will and attitudes of the participating professionals, disparity in distribution of funds, lack of adequate healthcare resources or facilities or a lack of communication structures to facilitate inter-professional consultation (Moore et al.,2014). Negative attitudes from team members can result in the creation of a hierarchy which can impact the ultimate goal of delivering patient-centred care. Disparity of distribution of funds can result in certain specialities being severely underfunded thus affecting their ability to provide maximum care for the patient. For example, the exercise class attended by Patient “X” does not operate on NHS funding despite the positive effect supervised exercise has on leg ulcer patients. The lack of funding can affect the sustainability of the scheme which can result in a breakdown of the interdisciplinary care
Venous leg ulceration is defined as “an area of discontinuity of the epidermis and the dermis on the lower leg persisting for at least four weeks”. There are several aetiologies of leg ulcers but the most common are, chronic venous hypertension and peripheral arterial occlusive disease (Duff et al., 1999).
Patients with venous leg ulcers have a dysfunction of the calf muscle pump (CMP) which is the main mechanism by which blood returns to the heart from the lower limbs. A defective CMP results in reduced ankle range of motion (ROM) and calf muscle activity which are the two main components of CMP (Orr et al., 2017). Araki et al., (1994) demonstrated the role of the CMP in the pathogenesis of venous ulcer. Several studies have also demonstrated that, a defective CMP and poor ankle ROM are associated with prolonged healing of leg ulcers (O’Brien et al., …show more content…
This includes but not limited to, the will and attitudes of the participating professionals, disparity in distribution of funds, lack of adequate healthcare resources or facilities or a lack of communication structures to facilitate inter-professional consultation (Moore et al.,2014). Negative attitudes from team members can result in the creation of a hierarchy which can impact the ultimate goal of delivering patient-centred care. Disparity of distribution of funds can result in certain specialities being severely underfunded thus affecting their ability to provide maximum care for the patient. For example, the exercise class attended by Patient “X” does not operate on NHS funding despite the positive effect supervised exercise has on leg ulcer patients. The lack of funding can affect the sustainability of the scheme which can result in a breakdown of the interdisciplinary care