The development of a national guideline on the management of leg ulcers

This paper describes the development of an evidence-linked clinical guideli ne for the management of uncomplicated venous leg ulcers. Guidelines are developed to provide recommendations for clinical practice w hich are based on summaries of good quality research evidence. The aim of the guideline discussed in this article is to direct primary hea lth care practitioners to the most effective method of assessment and treat ment of venous leg ulcers and to discourage practices that do not have conv incing or sufficient evidence of effectiveness. The three most important steps to the development of a valid clinical guide line are: basing recommendations on the best available evidence; explicit l inkage between guideline recommendations and quality of evidence; and the i nvolvement of a multidisciplinary group. The steps are discussed in relation to the development of the guideline alo ngside an introductory presentation on the role guidelines can play in impr oving practice. Issues arising from guideline development such as valid ways of obtaining p atient input and lack of evidence are also discussed.