Chronic leg ulceration is an increasing burden in the UK, both financially to the health service and on a human level. This first article in a four-part series, which looks at leg ulcer management and understanding compression therapy, explores the cardiovascular system, the underlying causes of lower limb problems, and the risk factors for leg ulceration. An overview of how compression therapy works and an introduction to the options available for patients and clinicians in this field of practice is also given. Subsequent articles in the series will look at holistic assessment and clinical decision-making in leg ulcer management, understanding compression hosiery and adjustable wraps, as well as compression bandaging and skin care
This article examines current guidelines and best practice statements for the treatment and management of chronic venous leg ulcers (VLUs). There is a need for continuous professional development (CPD) for community staff, who are constantly under pressure to maintain evidence-based practice when dealing with the complex, clinical and challenging environment associated with chronic venous leg ulcers. This article highlights the importance of patient assessment, management and treatment options, including the gold standard of compression therapy and new options available
Venous leg ulceration can be a chronic problem that has a negative effect on patients’ quality of life and is very expensive in terms of healthcare resources. The scale of the problem is continually increasing due to the ageing population, however, the standard of care across the UK varies despite a clear relationship between accurate assessment of the patient and the delivery of effective compression therapy. One of the major obstacles to the delivery of effective treatment is the reluctance of some patients to concord with prescribed compression therapy and there are a variety of reasons for this, including a lack of patient understanding of the importance of compression, or clinicians’ lack of knowledge or experience leading to poor patient education. The authors suggest, however, that maintaining patient concordance with compression therapy can result in effective healing. Central to this is the development of an effective therapeutic relationship between the clinicians and the patient and their family/carers and this article provides an overview of how one team of nurses were able to achieve this.
By reading the article, you can learn all about the key principles of subjects that are vital to your role as a community nurse. Once you have read the article, visit www.jcn.co.uk/learning-zone/ to evaluate your knowledge on this topic by answering the 10 questions in the e-learning unit; all answers can be found in the article. If you answer the questions correctly, you can download your certificate, which can be used in your continuing professional development (CPD) portfolio as evidence of your continued learning.
Compression therapy can play a vital role in improving the quality of life for those with chronic venous insufficiency, chronic oedema and lymphoedema (Lymphoedema Framework, 2006; World Union of Wound Healing Societies [WUWHS], 2008). In particular, compression bandaging can facilitate wound healing and oedema reduction in the treatment phase of management, before further healing and maintenance with compression hosiery.
In each issue of JCN we ask a clinical expert in a particular field to take a look at a therapy area and examine some everyday problems that community nurses may experience. In this issue, we look at an important precursor to compression therapy...
Compression therapy is the ‘gold standard’ for patients with lower limb problems. But achieving success is about more than simply applying compression bandaging or hosiery. We asked Trudie Young, tissue viability nurse and director of education and training at the Welsh Wound Innovation Centre, how to ensure that the limb is properly prepared to receive compression, a process that involves assessment, good skin care and debridement.
The recent and ongoing changes to the NHS were instigated to absorb the increasing costs of an ageing population: the NHS needs to save £15–20 billion by the end of 2013/14 for reinvestment into frontline services (Department of Health [DH], 2010a; 2010b).
David Gray, Professor of Tissue Viability, Tissue Viability Practice Development Unit, Birmingham City University, and Clinical Nurse Specialist Tissue Viability, NHS Grampian, Aberdeen
