Factors influencing concordance with compression stockings after venous leg ulcer healing

Jull, Andrew; Mitchell, Nathan; Arroll, J; Jones, Meril; Waters, Jill; Latta, A; Walker, N.; Arroll, Bruce

doi:10.12968/jowc.2004.13.3.26590

Cited by 66 publications

(68 citation statements)

References 6 publications

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“…Results of our study confirm the previous findings in this area 26,27,30. However, it was related to CVD duration and severity of symptoms.…”

Section: Discussionsupporting

confidence: 91%

Factors affecting patients’ self-management in chronic venous disorders: a single-center study

Barański¹,

Chudek²

2016

PPA

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BackgroundThe conservative treatment of chronic venous disorders (CVDs) includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors.ObjectiveThe aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management.MethodsA structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23–87 years). All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification.ResultsPharmacotherapy was the most frequently (85.0% of respondents) used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99–3.05]) and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16–2.62]) were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08–3.03]). Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61–3.88]) and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35–26.4]). Longer duration of CVD (≥15 years) increased (OR =1.78 [95% CI 1.16–2.71]) while obesity decreased (OR =0.38 [95% CI 0.20–0.72]) the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97–2.90]). Physiotherapy was rarely used by the patients.ConclusionObesity and longer duration of CVDs increase the use of venoactive drugs. Subjects with longer duration of the disease and without obesity are more likely to utilize compression therapy, the method considered to be the most effective but difficult in CVD self-management. Females are more prone to lifestyle changes and the use of heparin-containing ointments. There is an unmet need for health promotion regarding available CVD treatment methods and proper weight control measures to support CVD self-management.

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“…Results of our study confirm the previous findings in this area 26,27,30. However, it was related to CVD duration and severity of symptoms.…”

Section: Discussionsupporting

confidence: 91%

Factors affecting patients’ self-management in chronic venous disorders: a single-center study

Barański¹,

Chudek²

2016

PPA

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“…STSG in our patient population was very effective with 100% graft take and complete healing still evident at 1 year. This is in comparison to venous stasis ulcers treated with unna boot followed by STSG described almost 50% recurrence of the ulcer within 3 months of discharge (24).…”

Section: Key Pointsmentioning

confidence: 64%

Vacuum‐assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement

Raad

Lantis

Tyrie

et al. 2010

International Wound Journal

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Patients with massive venous stasis ulcers that have very high bacterial burdens represent some of the most difficult wounds to manage. The vacuum-assisted closure (VAC) device is known to optimise wound bed preparation; however, these patients have too high a bacterial burden for simple VAC application to facilitate this function. We present the application of the VAC with instillation of dilute Dakins solution as a way of bacterial eradication in these patients. Five patients with venous stasis ulcers greater than 200 cm(2) that were colonised with greater than 10(5) bacteria were treated with the VAC instill for 10 days with 12.5% Dakins solution, instilled for 10 minutes every hour. Two patients had multi-drug-resistant pseudomonas, three with MRSA. All the five had negative quantitative cultures, prior to split thickness skin graft with 100% take and complete healing at 1 year. Adequate delivery of bactericidal agents to the infected tissue can be very difficult, especially while promoting tissue growth. By providing a single delivery system for a bactericidal agent for a short period of time followed by a growth stimulating therapy, the VAC instill provides a unique combination that appears to maximise wound bed preparation.

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“…10,16 One possible explanation is that the typical patient may be unable or unwilling to tolerate these high compression bandages for any length of time or may have difficulty applying them, although we do not have data to support this conclusion. However, Jull et al 17 found that patients were less likely to wear compression dressings/stockings if they considered them uncomfortable. Another possibility is that some staff might not have been skilled in applying the compression bandaging.…”

Section: Discussionmentioning

confidence: 99%

Why Do Chronic Venous Leg Ulcers Not Heal?

Jones

2009

Journal of Nursing Care Quality

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Chronic venous leg ulcers account for the majority of lower extremity ulcers and represent a serious health and financial burden. Although several clinical practice guidelines and systematic reviews are available to guide treatment decisions, healing rates have not improved over the last decade. This research study illustrates some of the limitations of relying on existing databases to guide wound management as well as the importance of considering patient preferences, staff knowledge and skill, and available resources.

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Factors influencing concordance with compression stockings after venous leg ulcer healing

Abstract: Many factors previously thought to influence concordance appear to have little impact on compression-stocking use in people whose venous leg ulcers had healed.

Cited by 66 publications

References 6 publications

Factors affecting patients’ self-management in chronic venous disorders: a single-center study

Factors affecting patients’ self-management in chronic venous disorders: a single-center study

Vacuum‐assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement

Why Do Chronic Venous Leg Ulcers Not Heal?

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Factors influencing concordance with compression stockings after venous leg ulcer healing

Abstract: Many factors previously thought to influence concordance appear to have little impact on compression-stocking use in people whose venous leg ulcers had healed.

Cited by 66 publications

References 6 publications

Factors affecting patients&rsquo; self-management in chronic venous disorders: a single-center study

Factors affecting patients&rsquo; self-management in chronic venous disorders: a single-center study

Vacuum‐assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement

Why Do Chronic Venous Leg Ulcers Not Heal?

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Factors affecting patients’ self-management in chronic venous disorders: a single-center study

Factors affecting patients’ self-management in chronic venous disorders: a single-center study