Compression therapy for venous leg ulcers.
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Biomedical subjects
Publications and source records attributed to N Cullum.
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The authors have conducted a series of pressure sore prevalence surveys within one health district over a 4-year period. Additional surveys of the availability and deployment of pressure redistributing (PR) bed mattresses have also been made within the same district. The prevalence of pressure sores increased from 6.8% (1986) to 14.2% (1989) while the available stocks of PR mattresses increased from 69 (1987) to 186 (1989). Our results appear to question the common assumption that successful pressure sore prevention can be achieved through expanding the stocks of PR mattresses. Five possible reasons why the increase in mattress provision was matched with an increased prevalence of pressure sores are forwarded. The use of measures of prevalence rather than incidence rates to monitor the effects of clinical initiatives is discussed.
As a preliminary to a larger, prospective study of intrinsic factors associated with pressure sore development in a population of elderly hospital in-patients, this retrospective study of patients who had participated in an earlier, unrelated study was completed. The results of biochemical and haematological analyses from admission, together with details of nursing care, were obtained from medical and nursing notes, and analysed in relation to the condition of the pressure areas of each patient, which had been documented by a single observer throughout the period of study. The relationships between intrinsic factors such as serum protein concentration and systolic blood pressure, and the presence of, or tendency to develop pressure sores is examined and discussed in the light of a need for more specific and sensitive risk assessment tools.
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The treatment of uncomplicated leg ulcers has not always been carried out effectively. In this article, the authors introduce an evidence-based clinical guideline for the treatment of uncomplicated leg ulcers and highlight some of the key recommendations. This is to be launched at Nursing Standard's conference on evidence-based nursing this week.
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This article summarises the findings of a systematic review carried out by the NHS Centre for Reviews and Dissemination and the Center for Evidence-Based Nursing. Based on a rigorous analysis and synthesis of available research, the review concludes that training in the assessment of leg ulcers and the correct application of compression therapy appears to be more important than the particular products used. Recommendations for audit are also reported.
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