Improved healing rates for chronic venous leg ulcers: Pilot study results from a randomized controlled trial of a community nursing intervention

Abstract

Venous leg ulcers are a frequent source of chronic ill-health and a considerable cost to health-care systems. This paper reports pilot study results from a randomized controlled trial to determine the effectiveness of a community-based 'Leg Club' environment on improving healing rates of venous leg ulcers. Leg Clubs offer a setting where people with similar problems can socialize in a supportive, information-sharing environment. A sample of 33 clients with a below-knee venous leg ulcer were randomized to treatment, either in their own homes or in a community Leg Club. Treatment was provided to all participants, whether in the control group or intervention group, by a team of trained wound-care nurses following evidence-based assessment and treatment guidelines. Data were collected on admission to the study and at 12 weeks from admission. Results showed a significant improvement in healing in the intervention group compared to the control group, as measured by ulcer area size and Pressure Ulcer Scale for Healing scores. These results suggest that a community Leg Club environment provides benefits additional to wound care expertise and evidence-based care. Knowledge gained from this study provides evidence to guide service delivery and improve client outcomes.

Depression and quality of life in patients with chronic wounds: ways to measure their influence and their effect on daily life

“…Edwards et al 49 focused on analyzing healing rates of venous leg ulcers of patients who were part of a community-based Leg Club vs patients with (nursing) treatment at home. They demonstrated that the attendance at the Leg Club provided a wound-healing benefit for the attending patients.…”

The impact of chronic venous leg ulcers: a systematic review

“…Excluded studies were published prior to 1990, focused on a single domain of QoL such as pain, 22 were therapy, 23 product, 24,25 or intervention focused 26,27 or developed, evaluated or compared QoL instruments without comparison data from unaffected subjects. [28][29][30] Search strategies.…”

Family, Friends and Social Support

“…It is based in a nonmedical setting such as a community, church or village hall, where those with leg wounds can have collective treatment and share their experiences, there is also open access, meaning that no appointment is required. Community based interventions also provide patients with information about their wound and how to care for their wound as well as a number of strategies with living with a wound and overcoming practical difficulties from health professionals and other patients who have similar wound related problems (Edwards et al 2005 ). Here, the reintegration of leg ulceration sufferers into the social domain is encouraged, whilst the clubs have also proved successful in progressing the removal of the negative stigma associated with such ulcerations.…”

“…It has been suggested that health care practitioners should encourage patients to become more involved in self-management, through such social support self-help groups to reduce both pain and the consequent stress it causes (Price et al 2007 ;Moffatt et al 2009 ;Brown 2010 ). 'Leg clubs' can provide individuals with an environment whereby those with similar problems can socialise in a supporting, information-sharing environment (Edwards et al 2005 ). There have been a number of 'leg club' interventions set up within a community setting that have been developed which aim to improve an individual's well-being, some of these include, 'Lively legs' programme (Heinen et al 2012 ); 'Look after your legs' support group (Freeman et al 2007 ); and the 'Lindsay leg club' ® (Lindsay 2013 ).…”