Interventions for helping people adhere to compression treatments for venous leg ulceration

Weller, Carolina; Buchbinder, Rachelle; Johnston, Renea V

doi:10.1002/14651858.cd008378.pub3

Cited by 67 publications

(54 citation statements)

References 64 publications

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“…One patient preferred to wear the geko™ devices while standing at work for the entire shift. When standing, with 0 ∘ of knee flexion, compared with sitting with knee flexed to 90 ∘ , the common peroneal nerve moves away from the fibular head by an average of 17 mm, (30) and visual response of the muscles to the geko™ device decrease. When Jawad et al tested the geko™ response compared to IPC in blood flow volume and velocity, they used a 'threshold setting', the minimum setting to elicit a minor muscular contraction in the calf, compared to the 'normal clinical setting' wherein the upward and outward twitching of the foot is seen (18).…”

Section: Discussionmentioning

confidence: 98%

Refractory venous leg ulcers: observational evaluation of innovative new technology

Harris¹,

Loney²,

Brooke³

et al. 2017

International Wound Journal

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This observational case series reports the evaluation of a novel neuromuscular electrical stimulation device (geko™) that stimulates the common peroneal nerve at the fibular head as an adjunctive therapy in patients with non-healing venous leg ulcers. The aim was to evaluate and determine if the geko™ device was effective in this population and should be added to the medical supply formulary. Patients whose wounds had failed to heal within 24 weeks of standard therapy were identified in two community settings in Ontario. A total of 11 patients consented to the evaluation with a combined 107-year history of recalcitrant leg ulcers. Although the pre-geko™ healing rate was unknown, all ulcers were considered non-healing. With geko™, the average weekly percentage reduction in surface area for all patients was 4⋅5% and for the six adherent to geko™ and best practices 7⋅0%. By comparison, the average weekly percentage reduction for measurable wounds in the five non-adherent patients was 1⋅8%. Requirements for success appear to include an arterial status adequate for healing, effective and prompt management of wound infections and adherence to the treatment schedule. The geko™ device has been added to the medical supply formulary in one centre and is pending in the other.

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Section: Discussionmentioning

confidence: 98%

Refractory venous leg ulcers: observational evaluation of innovative new technology

Harris¹,

Loney²,

Brooke³

et al. 2017

International Wound Journal

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“…Although there has been a growing number publications addressing the subject of "ulcer and pain", further studies on the impact of interventions on pain are desirable. This is also formulated in the Cochrane review on "Compression Therapy for Venous Leg Ulcers" [35].…”

Section: Leg Ulcermentioning

confidence: 99%

Pain and pain management in dermatology

Beiteke¹,

Bigge

Reichenberger

et al. 2015

J Deutsche Derma Gesell

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SummaryIt is estimated that 23 million Germans suffer from chronic pain. A recent survey has revealed that 30 % of chronic pain patients are dissatisfied with their pain management. Furthermore, five million Germans suffer from neuropathic pain, 20 % of whom are inadequately treated. Pain is also a symptom of many dermatologic diseases, which is mostly somatic and may be classified as mild in the majority of cases. Nevertheless, research on the quality of life (QoL) has increasingly shown a marked impairment of QoL by moderate pain such as in psoriatic arthritis. Severe pain is associated with herpes zoster (shingles), leg ulcers, and pyoderma gangrenosum. This article addresses the basics of pain classification and, in a short excerpt, pain transduction/transmission and modulation. The use of standardized diagnostic scales is recommended for the purpose of recording and monitoring pain intensity, which allows for the optimization of therapy and consistent interdisciplinary communication. Any dermatology residency program includes the acquisition of knowledge and skills in pain management. This review therefore aims to present fundamental therapeutic concepts based on the expanded WHO analgesic ladder, and describes a step-wise therapeutic approach and combination therapies. The article focuses on the pain management of the above-mentioned severely painful, conservatively treated dermatoses. Besides well-established therapeutic agents and current therapeutic standards, it discusses specific options based on guidelines (where available). Current knowledge on peri-and postoperative pain management is briefly outlined. This article addresses:  The fundamentals of the classification and neurophysiology of pain;  Standards for pain documentation in children and adults;  General standards for pharmaceutical pain management;  Current specific treatment options for postherpetic neuralgia, leg ulcers, and pyoderma gangrenosum in conjunction with the expanded WHO analgesic ladder.

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“…To achieve this, a PressCise bandage with a lower target pressure, combined with an outer stiffer bandage layer, might be a good combination for mobile patients and patients with arterial insufficiency. In addition, special attention should be paid to subjective patient experiences in relation to the treatment as pain, discomfort and bulk are factors that can compromise patients' willingness to adhere to the treatment protocol and thereby prolong the healing process (8,15,16). The difference calculated per nurse between ankle and calf on each single measurement (the three repetitions as an index at B1 and C) The difference calculated per nurse between ankle and calf; the sample size is n = 21 in each case The difference calculated per nurse between pairs of states; the sample size is n = 21 in each case…”

Section: Implications For Clinical Practice and Further Researchmentioning

confidence: 99%

An investigation of the ability to produce a defined ‘target pressure’ using the PressCise compression bandage

Wiklander

Andersson

Källman

2015

International Wound Journal

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Compression therapy is the cornerstone in the prevention and treatment of leg ulcers related to chronic venous insufficiency. The application of optimal high pressure is essential for a successful outcome, but the literature has reported difficulty applying the intended pressure, even among highly skilled nurses. The PressCise bandage has a novel design, with both longitudinal and horizontal reference points for correct application. In the current experimental study, the results for the general linear model, where the data set is treated optimally, showed that all 95% confidence intervals of the expected values for pressure were, at most, 5 mmHg from the target value of 50 mmHg, independent of the position on the leg and the state of activity. Moreover, even nurses with limited experience were consistently able to reach the targeted pressure goal. Future studies are needed to determine how well the bandage works on legs of different shapes, the optimal way of using the bandage (day only or both day and night) and whether the bandage should be combined with an outer bandage layer. In addition, special attention should be paid to subjective patient experiences in relation to the treatment as pain, discomfort and bulk are factors that can compromise patients' willingness to adhere to the treatment protocol and thereby prolong the healing process.

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Interventions for helping people adhere to compression treatments for venous leg ulceration

Cited by 67 publications

References 64 publications

Refractory venous leg ulcers: observational evaluation of innovative new technology

Refractory venous leg ulcers: observational evaluation of innovative new technology

Pain and pain management in dermatology

An investigation of the ability to produce a defined ‘target pressure’ using the PressCise compression bandage

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