The Walsall Community Risk Score Calculator has been in use for the past 8 years. Outcomes from a trust-wide prevalence audit identified that this assessment tool may benefit from re-evaluation. This study examined the tool's validity and reliability and has resulted in some changes being made to the original score. To assess validity, a cross-sectional study of 720 patients was undertaken looking at the incidence of pressure damage, despite intervention, over a 12-week period. Using logistic regression analysis new weightings for each category were developed. This also led to the removal of one factor (bodily pain) which did not appear to contribute to increased risk of pressure damage. The updated score shows an improved prediction of pressure sore development compared with the existing method.

Objective: To evaluate health-related quality of life (HRQoL) in a prospective randomized trial of patients suffering from venous ulceration comparing a generic four-layer elastic bandage (4LB) with a new cohesive short stretch bandage system (CSSB). Methods: Randomized prospective open parallel groups trial in community leg ulcer clinics within twelve trusts in England and Northern Ireland. Patients newly presenting for treatment suffering from chronic venous ulceration, with ankle brachial pressure index (ABPI) >0.8 were entered into the trial. Patients were asked to complete the Nottingham Health Profile (NHP) at entry, at end of trial period (withdrawal or healing), and at 24 weeks. Principal analysis was the comparison of final NHP scores using linear regression with baseline scores entered as a covariate. Results: In all, 154 of the 156 patients who entered the trial completed the initial questionnaire, with 139/154 (90.2%) patients completing at least one follow-up questionnaire. Improvements were noted for all scores after 24 weeks. The improvements were significantly greater in the 114 patients whose ulcers had healed compared with the 40 whose ulcers remained open in the domains of bodily pain (mean difference [d]=13.2, 95% CI 3.6-22.9, P =0.008), emotional reactions (d=10.5, 95% CI 2.8-18.1, P =0.007) and social isolation (d=8.5, 95% CI 1.2-15.9, P =0.024). There were similar mean scores between the 72 patients treated with the 4LB and the 82 patients treated with CSSB for all domains of the NHP, the largest adjusted difference favoured CSSB for energy (d=3.6, 95% CI-4.3-11.4, P =0.37). Conclusions: Patients suffering from leg ulceration show improvements in perceived health following effective ulcer management. The two bandage systems achieved similar improvements in perceived health over 24 weeks.

Leg ulcer management is increasingly becoming a nurse-led specialty with practitioners implementing evidence-based care that is efficient, effective and resourceful. A large percentage of patients with leg ulceration are treated in the community. This article will discuss the healing rates and management of venous leg ulcers, many of which were longstanding problems, in a community leg ulcer clinic.

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The Walsall Community Risk Score Calculator has been in use of the past 8 years. Outcomes from a trust-wide prevalence audit identified that this assessment tool may benefit from re-evaluation. This study examined the tool's validity and reliability and has resulted in some changes being made to the original score. To assess validity, a cross-sectional study of 720 patients was undertaken looking at the incidence of pressure damage, despite intervention, over a 12-week period. Using logistic regression analysis new weightings for each category were developed. This also led to the removal of one factor (bodily pain) which did not appear to contribute to increased risk of pressure damage. The updated score shows an improved prediction of pressure sore development compared with the existing method.