Chronic venous leg ulcers: effect of a community nursing intervention on pain and healing

Edwards, Helen; Courtney, Mary D.; Finlayson, Kathleen; Lindsay, Ellie; Lewis, Caroline; Shuter, Patricia; Chang, Allan

doi:10.7748/ns2005.09.19.52.47.c3950

Cited by 43 publications

(53 citation statements)

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“…Some reported healing in groups receiving standard care—at ≤12 weeks, ranging from 23.5% to 45.1%; at 24 weeks: 38.5%; at 6 months: 73.6%; and at 12 months: 67.7% . Some reported healing in groups receiving specialist care—at ≤12 weeks, ranging from 43.6% to 73.0%; and at 24 weeks: 57.6% . In a group receiving specialist care, 96.8% of low‐risk patients and 25.0% of high‐risk patients healed in 24 weeks…”

Section: Resultsmentioning

confidence: 99%

Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters

McCosker

Tulleners

Cheng

et al. 2018

International Wound Journal

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Chronic wounds are a significant problem in Australia. The health care‐related costs of chronic wounds in Australia are considerable, equivalent to more than AUD $3.5 billion, approximately 2% of national health care expenditure. Chronic wounds can also have a significant negative impact on the health‐related quality of life of affected individuals. Studies have demonstrated that evidence‐based care for chronic wounds improves clinical outcomes. Decision analytical modelling is important in confirming and applying these findings in the Australian context. Epidemiological and clinical data on chronic wounds are required to populate decision analytical models. Although epidemiological and clinical data on chronic wounds in Australia are available, these data have yet to be systematically summarised. To address these omissions and clarify the state of existing evidence, we conducted a systematic review of the literature on key epidemiological and clinical parameters of chronic wounds in Australia. A total of 90 studies were selected for inclusion. This paper presents a synthesis of the evidence on the prevalence and incidence of chronic wounds in Australia, as well as rates of infection, hospitalisation, amputation, healing, and recurrence.

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Section: Resultsmentioning

confidence: 99%

Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters

McCosker

Tulleners

Cheng

et al. 2018

International Wound Journal

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“…Studies on patients with chronic leg ulcers have reported the average duration of these ulcers is around 12–13 months [2,3], around 60–70% of patients have recurring ulcers [4], 24% of patients are hospitalised because of the ulcers and most people suffer from the condition for an average of 15 or more years [3]. Care for chronic wounds is reported to cost 2-3% of total health care spending in developed countries [5,6] and these costs are set to rise with ageing populations [7].…”

Section: Introductionmentioning

confidence: 99%

Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care

Edwards

Finlayson

Courtney

et al. 2013

BMC Health Serv Res

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100

156

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BackgroundChronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers.MethodsA sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission.ResultsRetrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p < 0.001) and Kaplan-Meier survival analysis found the median time to healing was 12 weeks (95% CI 9.3–14.7). Implementation of evidence based care was significantly related to improved healing outcomes (p < 0.001).ConclusionsThis study highlights the complexities involved in accessing expertise and evidence based wound care for adults with chronic leg or foot ulcers. Results demonstrate that access to wound management expertise can promote streamlined health services and evidence based wound care, leading to efficient use of health resources and improved health.

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“…It is evident that pain, exudate, odour, and the psychological impact of unsightly wounds and bandages often result in limited and impaired mobility, embarrassment and subsequent © NURSING STANDARD / RCN PUBLISHING social isolation (Persoon et al 2004, Edwards et al 2005a. Brown (2005b) discussed how chronic leg ulcers affect a person's social life and subsequently cause social isolation.…”

Section: Social Isolationmentioning

confidence: 99%

“…Because patients with leg ulcers are usually treated at home, community nurses are often the only social contact the patient will have (Edwards et al 2005a). This level of social contact is considered insufficient in meeting factors that are essential for effective management of leg ulceration, such as the need for peer support, information and empathy (Lindsay 2001).…”

Section: Social Isolationmentioning

confidence: 99%

Psychosocial effects of living with a leg ulcer

Parker

2012

Nursing Standard

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Leg ulcers can have a significant effect on patients' quality of life. Treatment needs to be holistic, focusing on managing and treating the wound, as well as recognising the psychosocial effects that patients may experience. This article reviews relevant literature on the psychological and social effects of leg ulceration and discusses how healthcare professionals can address patients' needs in this area to promote overall health and optimise wellbeing.

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Chronic venous leg ulcers: effect of a community nursing intervention on pain and healing

Abstract: Results from this study have implications for health professionals providing care for clients with chronic leg ulcers.

Cited by 43 publications

References 0 publications

Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters

Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters

Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care

Psychosocial effects of living with a leg ulcer

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