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. 2019 Apr;16(2):406-419.
doi: 10.1111/iwj.13048. Epub 2018 Nov 28.

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

Carolina D Weller  1 , Victoria Team  1 , John D Ivory  2 , Kimberley Crawford  1 , Georgina Gethin  2
Affiliations

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

Carolina D Weller et al. Int Wound J. 2019 Apr.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Int Wound J. 2019 Aug;16(4):1074. doi: 10.1111/iwj.13165. Epub 2019 Jul 11. Int Wound J. 2019. PMID: 31328899 Free PMC article. No abstract available.

Abstract

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 determine 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 can 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 safe 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.

Keywords: ankle-brachial pressure index (ABPI); clinical practice guidelines; consistency; scoping review; venous leg ulcers.

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Conflict of interest statement

All persons designated as authors qualify for authorship. Each author has participated sufficiently in the work to take public responsibility for the content.

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