Tissue Viability & Lymphoedema Service

Welcome to the Surrey Downs Tissue Viability and Lymphoedema service. We are a friendly, approachable highly experienced team of nurses working in Tissue Viability and Lymphoedema with years of experience working in the NHS.

We ensure that the care provided is delivered to a high standard, and is research and evidence based.

We aim to work towards an improved wound care journey for our Surrey Downs patients. We endeavour to reduce pressure ulcers, heal complex wounds in a timely manner and reduce leg ulcers prevalence, and provide lymphoedema/ lipoedema support and management.

Please note we are not an emergency service.

 If you have urgent concerns please speak with the allocated GP, call NHS 111, or refer to another service.

 

How can we help you?

We support a variety of community services to assess, diagnose, and treat a wide range wound care, and lower limb related issues. Our goal is to help you to improve your wound healing rates, prevent the re-occurrence of pressure ulcers, and lower limb ulcers, improve your health and quality of life, prevent complications, and feel your best.

We follow guidance and protocols lain down by national and local policies in general nursing, Tissue Viability and Lymphoedema.

We treat all patients and clinicians with respect, dignity, and awareness of the diverse communities we serve.

We offer support for various conditions, including:

  • Complex non healing wounds
  • Lower limb / Leg ulcers
  • Pressure ulcers
  • Lymphoedema and Lipoedema management

Where can we see you?

Tissue Viability 

We visit patients in GP premises, home settings and nursing/residential homes in Surrey Downs locations.

We also run an Outpatients clinic at Leatherhead Community Hospital once a week (appointment only, not a walk in)

 

Lymphoedema

We run a clinic twice a week from Leatherhead community hospital. (Appointment only, not a walk in)

We are also available for remote advice and discussion if you are unable to attend clinic appointments.

Who is the tissue viability service for?

Urgent referrals for patients with very complex conditions and wounds

  • Unexplained rapid deterioration of a wound
  • Category 3 and 4 pressure ulcers for classification DATIX if no photograph a visit may require three to four working days 
  • Multiple Category 2s only
  • Diabetic foot and Ischaemic foot ulcers must be referred to Podiatry
  • All the above will be triaged by the Tissue Viability Team to ascertain level of urgency.

 

Non-urgent referrals for patients with less complex wounds and conditions 

  • Wounds that have failed to heal following eight weeks optimal care
  • Longstanding leg ulcers (Arterial/Venous)
  • Atypical wounds for diagnosis and triage
  • Patients with wet leaky legs despite giving optimal care
  • Topical Negative Therapy (TNP). We require 48 hours’ notice to request dressings/therapy unit
  • For a TBPI if abnormal ABPI above 1.3 or very swollen limbs making routine ABPI difficult.

 

Exclusion criteria 

  • Wounds that are healing as expected.
  • Wounds that are being seen by Podiatry/Dermatology and Vascular unless specific to Tissue Viability Service.
  • Cellulitis without active ulceration.
  • Skin conditions no open wounds (Dermatology).
  • Those previously seen by the Tissue Viability Service who have no new identified related complications.
  • Non-concordant patients who have the capacity and have been advised by the Tissue Viability Service on previous occasions and have declined treatment options offered, unless they have now decided to comply with treatment.
  • Cat 1-2 pressure ulcers/moisture lesions MASD unless concerns regarding deterioration despite treatment.
  • For doppler’s/ABPI only.
  • Hosiery garment advice measurement.

Who is the lymphoedema service for?

Urgent referrals:  For Palliative patients and Lymphoedema caused by cancer/ treatment for cancer

 

Non-urgent referrals

  • Oedema which has been present for three months or longer
  • Primary or secondary Lymphoedema
  • Signs/symptoms or a diagnosis/suspected diagnosis of Lipoedema.
  • The clinic is a stand-alone outpatient service run by a lymphoedema practitioner with input from members of a multi-professional team, as necessary. Referrals can be made by GP surgeries, Community Nursing Teams and local hospitals.

 

Exclusion criteria 

  • Patients are not suitable to be referred to the service if they have any chronic wounds. Legs should be dry, or have wounds which have nearly healed and can be managed with a small adhesive dressing only.
  • Patients with acute, unstable heart or renal failure will require referral via their consultant or confirmation from their GP that they are safe to establish in compression.
  • Housebound patients - Can only be seen in exceptional circumstances, and/or Palliative patients