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Why you should read this article: • To enhance your understanding of age-related skin changes and susceptibility to wounds in older age • To increase your awareness of the principles of wound assessment and management in older people • To recognise that wound healing is not always achievable or realistic in an older person. Age-related skin changes lead to increased susceptibility to skin damage and delayed wound healing, which is exacerbated by comorbidities such as cardiovascular disease and diabetes mellitus. In some cases, wound healing is not achievable or realistic and this needs to be reflected in the wound management plan. To improve outcomes and experience in older people presenting with wounds it is important to select wound management products that protect the wound bed and surrounding skin, minimise trauma, reduce symptoms and/or promote healing. This article explores how conducting holistic wound assessments, setting realistic treatment aims, and using wound management strategies tailored to each person’s needs and wishes can have a positive effect on older people’s quality of life. [ABSTRACT FROM AUTHOR]

A venous leg ulcer (VLU) is defined as the loss of skin below the knee on the leg or foot in the presence of venous disease, which takes more than two weeks to heal. The prevalence of VLUs is increasing, especially in older people, which will increase the demand for nursing care. Development of a lower leg ulcer should trigger immediate assessment of risk factors for chronic venous disease followed by action to identify the cause and initiate treatment, which should prevent progression to more complex and chronic problems. Justification for choice of appropriate wound management and application of compression therapy should be based on the assessment and diagnosis. Management of patients with VLUs can be cyclical and lifelong, which highlights the importance of helping patients to understand the rationale for management strategies so that cooperation in self-care is achieved. [ABSTRACT FROM AUTHOR]

This article aims to explain the difference between venous and arterial leg ulcers, methods of treatment and prevention for each kind of ulcer, and the social and emotional impact of venous ulcers. [ABSTRACT FROM AUTHOR]

The Barnstaple Leg Club has been running for almost two years in north Devon providing treatment and support to older people with leg ulcers on a weekly basis. This article examines the concept of leg clubs and describes how the community nursing team that leads the club offers holistic care to local people. The nurses are able to see more patients than they would by carrying out home visits, healing their wounds and boosting their self-esteem and confidence, while at the same time reducing social isolation. [ABSTRACT FROM AUTHOR]

This section offers news briefs on research about nursing older people. A study has found that some patients developed post-thrombotic syndrome in the second year and was lowered in patients who used elastic compression stocking for two years. A review and meta-analysis has shown that a high intake of whole grain is associated with a lower risk of coronary heart disease, cardiovascular disease, and total cancer.

The article presents abstracts on topics related to nursing for older people which include the benefits of saturated fat, the benefits offered by dance and exercise after breast operations, and aspirin as the best treatment for leg ulcers.

Abstracts of several articles related to gerontological nursing are presented such as "Consumption of spicy foods and total and cause specific mortality: population based cohort study," by J. Lv and colleagues, "Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment," by J. Pagonabarraga and colleagues, and "Zinc-impregnated and odour-control two-layer compression," by J. Stephen-Haynes and R. Callaghan.

The article reports on the results of a study led by Markos Klonizakis from Sheffield Hallam University in England which aims to investigates whether exercise can improve outcomes for patients with chronic venous leg ulcers.

The article features community nurse Linda Harris, who invented the Harris Trolle, which allows nurses to bathe and cleanse leg ulcers at a height that is suitable for patients and nurses.

The article presents research articles from various journals including “Living a life in shades of grey” by Kouwenhoven and colleagues from the Journal of Advanced Nursing. “Spray-applied cell therapy with human allogeneic fibroblasts and keratinocytes for the treatment of chronic venous leg ulcers” by Kirsner and colleagues from the Lancet. “Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis” by Guermazi and colleagues from the British Medical Journal.

The article focuses on a study led by nurse Andrea Nelson from the University of Leeds which examined patients with venous leg ulcers who had not healed after six months or longer.

The article presents updates related to field of nursing. A study found that the frequency and duration of exercise have increased in patients with venous leg ulcers who underwent a nurse-led intervention. Particular focus is given to the suitability of telecare to older people with long-term conditions. Another study examined the effect of deep brain stimulation on patients with Alzheimer's disease.

This section offers news briefs related to the British nursing field including the recognition received by the Royal College of Nursing as one of the top employers in Great Britain, the awarding of a grant by the Queen's Nursing Institute to a project aimed at improving the care patients with leg ulcers in Northern Ireland, and the record number of requests for help received by Nurse Aid in January 2011.

The article reports that the Lindsay Leg Club Foundation launched an education program for its staff in leg clubs across Great Britain.

The article reports on nurse Ellie Lindsay developing a community-based approach to leg ulcer care, which grew into a network of clinics known as "leg clubs." The Lindsay Leg Club Foundation is a network for those involved in leg clubs. Typically, the clubs meet once a week, sometimes twice, and their aim is to empower members to participate in their own care in an environment that can case loneliness and isolation through peer support. Patients are treated collectively with an emphasis on positive health beliefs designed to counter the pain and fluid leakage associated with leg ulcers, which can have a devastating effect on people's lives.

This article reports that leg ulcer recurrence rates could be cut and the massive annual bill for wound care reduced dramatically if the benefit of leg Clubs' was more widely understood. Nurse expert Ellie Lindsay presented her ideas at the Conservative Party conference in Bournemouth, England, telling delegates that Leg Clubs run by her have reduced the recurrence of leg ulcers from 67 per cent to 4 per cent. More than half of district nurses' caseloads involve treatment for leg ulcers, contributing to an annual NHS bill of£ 1 billion. Lindsay, a category winner in the Nursing Standard Nurse 2003 awards, first opened a Leg Club in 1995. Designed to complement existing treatment, the clubs are held in non-medical venues where patients are educated and empowered to take decisions about their choice of treatment.