Wounds in chronic leg oedema

Abstract

Wounds and chronic oedema are common disorders, but rarely studied together. The objective of this cross-sectional study was to investigate the point-prevalence and risk factors of wounds on the leg, in chronic leg oedema. Forty sites in nine countries were included. Of 7077 patients with chronic leg oedema, 12.70% had wounds. Independent risk factors were: peripheral arterial disease (odds ratio (OR) 4.87, 95% confidence intervals (CI) 3.63-6.52), cellulitis within the past 12 months (OR 2.69, 95% CI 2.25-3.21), secondary lymphoedema (OR 2.64, 95% CI 1.93-3.60), being male (OR 2.08, 95% CI 1.78-2.44), being over 85 years of age (OR 1.80, 95% CI 1.23-2.62), underweight (OR 1.79, 95% CI 1.14-2.79), bed bound (OR 1.79, 95% CI 1.01-3.16), chair bound (OR 1.52, 95% CI 1.18-1.97), diabetes (OR 1.47, 95% CI 1.23-1.77), and walking with aid (OR 1Á41, 95% CI 1.17-1.69). 43.22% of those with wounds had clinically defined well-controlled oedema, associated with a significantly lower risk of wounds (OR 0.50, 95% CI 0.42-0.58, P < .001). Hard/fibrotic tissue (OR 1.71, 95% CI 1.19-2.48), and a positive Stemmers sign (OR 1.57, 95% CI 1.05-2.35) were associated with wounds. The study reinforces the importance of measures to control oedema, as controlled swelling was associated with a 50% lower risk of wounds.chronic oedema, leg ulcers, LIMPRINT, lymphoedema, wounds and injuries Key Messages• chronic leg oedema (oedema >3 months ) and wounds are frequent conditions, but have rarely been studied together. Little is known about mechanisms linking wounds and oedematous limbs

Yara Polikliniğine Başvuran Hastaların Yara Takip Sonuçlarının Değerlendirilmesi

“…Literatürde periferik dolaşım bozukluğu, kardiyovasküler sorunlar, diyabetes mellitus, nörolojik hastalıklar, beslenme sorunları vb. gibi yara oluşumu ve iyileşmesi üzerinde etkili pek çok risk faktöründen bahsedilmektedir (13,14). Çalışmadan elde edilen bulgulara bakıldığında hastaların çoğunluğunun diyabet (%75,9), kalp (%50) ve dolaşım sistemi (%43,7) hastalığı tanısı olduğu belirlenmiştir.…”

Prospects for the application of home care in chronic wound management

“…[ 5 , 6 ] Chronic wounds refer to wounds caused by various causes for more than 6 weeks, including arterial/venous ulcers, diabetic ulcers, traumatic ulcers, and pressure ulcers. [ 7 ] Due to the slow course of chronic wounds and the protracted healing, patients often bear heavy psychological pressure and economic burden. Nursing workers provide door-to-door services.…”

Getting Ready for Wound Certification

“…The Advanced Practice Certified Wound Care Nurse (CWCN-AP) and Certified Wound Care Nurse (CWCN) must be aware of the role infection and edema play in delayed wound healing as well as interventions that can treat or prevent these conditions. To reduce ulcer recidivism, patients often require education including the continued use of compression therapy in the long term even after ulcers have healed 3,7,9. Candidates preparing for WOCNCB wound certification should also be aware of patient considerations that would preclude the use of compression and what tests might be performed to ascertain whether compression is safe for patients.…”

“…3 Its use is associated with expedited wound healing and a decreased incidence of wounds. 7 Edema is more than just fluid; it contains proteins and other proinflammatory cellular waste products. It impairs wound healing through multiple mechanisms including decreased perfusion from the capillary bed to the wound surface, fibroblast inhibition, endothelial cell suppression, and proinflammatory accumulation of cellular waste products in the interstitial space.…”

“…To reduce ulcer recidivism, patients often require education including the continued use of compression therapy in the long term even after ulcers have healed. 3,7,9 Candidates preparing for WOCNCB wound certification should also be aware of patient considerations that would preclude the use of compression and what tests might be performed to ascertain whether compression is safe for patients.…”