Vascular Assessments

ABPI monitor

ABPI1 measurement on legs

  • WHY DO I NEED TO KNOW MY VASCULAR STATUS?
    • We test your vascular status to determine how good your bloodflow in your limbs are. When you know what your vascular status is you can also take preventative measures to prevent venous ulceration.  If you do have an ulcer this examinationwill also determine which treatment program would be the best for you to follow.
  • WHY DO WE DO AN ANKLE BRACHIAL PRESSURE INDEX (ABPI)?
    • We do an ABPI to be able to determine the blood flow in the lower legs.  This is done by using the Dopplex ABILITY diagnostic device which performs an automated ABPI simultaneously on both legs. This diagnostic test enables us to determine your vascular status. 
  • WHAT IS AN ABPI?
    • ABPI is the Ankle Brachial Pressure Index where the blood flow in your limbs are measured by comparing blood pressures in your arms with blood pressures in your legs. The value measured provides sufficient evidence according to international guidelines to what blood flow you have.  
      • Patients with arterial insufficiency will typicall have an ABPI <0.6
      • Patients with mixed arterial and venous insufficiency will typicall have an ABPI 0.6 -0.8
      • Patients with venous insufficiency will typically have an ABPI >0.8
  • ABPI AND COMPRESSION?
    • The ABPI value enables us to do a proper treatment plan or to refer you to the relevant interdisciplinary team member if needed.
    • Compression therapy is the gold standard when treating venous insufficiency 

ABPI full measurement

ABPI measurement

Advanced Wound Management

Lower Leg Ulcers

The first step in the treatment of any lower leg ulcer is to determine the type of ulcer since the different causes do require different management strategies.  This can be done by doing a full vascular assessment of the lower leg. A full vascular assessment includes the following:

  • Bilateral leg physical examination
  • Palpating all foot pulses
  • Ankle Brachial Pressure Index
  • Full patient history

wound cleansing 2 o

dressing o

ALLWMC M007

DEbridement 8 o

ALLWMC M025

ALLWMC M044

Venous Leg Ulcers (Also known as Varicose Vein Ulcers)

Once it is determined through the vascular examination that you do have a venous ulcer an individualised treatment plan is started.  The gold standard is implemented by starting treatment with multilayer compression bandages. Depending on the size of the wound and the possibility of infection dressing changes are adapted to the patient's own individual needs.  Infected wounds are often first treated 2-3 times per week untill the infection is resolved, there after bandages are done once a week.  Once the wound is healed the patient will be issued compression stockings which will need to be replaced every 6 months.  70% of all lower leg ulcers worldwide are venous leg ulcers and classic symptoms include:

  • A history of varicose veins
  • A history of oedematous (Swollen) legs which worsen as the day progresses.  Once the legs are elevated the oedema decreases with the aid of gravity.
  • Dark skin discolouration at the gait area (the area above the ankle below the calf).  This is also called lipodermatosklerosis
  • Non-healing large ulcers that are very wet and diffuse in shape
  • Patient has bounding pulses with good capillary refill

Arterial Ulcers

If there is no blood flow the wound will not heal. Referral to a Vascular Surgeon in order to address and improve the arterial insufficiency is therefore an essential part in the treatment process. Once the arterial insufficiency is addressed wound healing can occur.

Mixed Ulcers

Mixed ulcers requires modified compression therapy to facilitate healing and should be done after consulting the Vascular surgeon. Important is to treat the underlying cause first in combination with modified compression therapy.

Diabetic Foot Ulcers

The diabetic foot in itself is very complex and with diabetic patients a team approach is essential to manage blood sugar levels and other related pathologies. The focus of the centre is limb salvage and to safe the patient’s foot. Wound management is aimed at improving the patient’s quality of life.

We do thorough evaluations to ensure that treatment is optimal. Evaluations include:

  • Evaluating the risk for diabetic foot complications
  • Evaluating blood flow
  • Evaluating sensation

Complicated Wounds

These type of wounds are any wounds that does not follow the normal pathway of healing. This can be due to various factors such as Diabetes, Arterial insufficiency, Cancer, Immune disorders, skin disorders and many more. Goal of treatment is to first determine the cause by working together as a multi-disciplinary team. Holistic wound management forms the basis of all wound management.

Burn Wounds

When caring for patients with burn wounds it is important to remember that many factors
impact on the care that we are able to deliver. This is of particular relevance in the area of wound care. At the centre we aim to promote moist wound healing enabling faster closure of the wound with new epithelial cells. Advanced wound care products such as bioengineered tissue is used in severe cases. Essential in burn wound management is the after care in scar management where we utilize advanced products to prevent excessive scaring.

Allied Services

Part of our multi-diciplinary approach is the involvement of Podiatry service, an essential part of patient care

Podiatry Services

Podiatry Services

Podiatry services include:

  • Full biomechanical evaluation
  • Full neurological evaluation
  • Callous removal
  • Treatment of ingrown toenails
  • Specialised orthotics
  • Treatment of fungal nail infections
  • Web: Happy Feet Podiatrist

Podiatry Services

Podiatry Services