Prevention strategies for the recurrence of venous leg ulcers: A scoping review

Abstract

Venous leg ulcer (VLU) is the most severe manifestations of chronic venous disease, which has characterized by slow healing and high recurrence rates. This typically recalcitrant and recurring condition significantly impairs quality of life, prevention of VLU recurrence is essential for helping to reduce the huge burden of patients and health resources, the purpose of this scoping review is to analyse and determine the intervention measures for preventing recurrence of the current reported, to better inform healthcare professionals and patients. The PubMed, Embase, Web of Science, Cochrane Library databases, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wan Fang Data and Chongqing VIP Information (CQVIP) were accessed up to June 17, 2023. This scoping review followed the five‐steps framework described by Arksey and O'Malley and the PRISMA extension was used to report the review. Eleven articles were included with a total of 1503 patients, and adopted the four effective measures: compression therapy, physical activity, health education, and self‐care. To conclude, the use of high pressure compression treatment for life, supplementary exercise therapy, and strengthen health education to promote self‐care are recommended strategies of VLU prevention and recurrence. In addition, the importance of multi‐disciplinary teams to participate in the care of VLU in crucial.

Self‐management to prevent recurrence in venous leg ulcers: A concept analysis

“…Lifelong compression therapy is reported to be the foundation of recurrence prevention, with daily leg elevation and exercise also minimum recommendations. 1 , 8 , 9 , 10 , 11 , 12 However, recurrence continues, with research reporting general poor concordance with prevention strategy application. Furthermore, concordance with prevention applications appears to decrease over time, especially with regards to compression concordance.…”

“…Furthermore, concordance with prevention applications appears to decrease over time, especially with regards to compression concordance. 9 , 12 , 13 , 14 Research discusses a lack of understanding, discomfort, physical limitations and psychosocial impact being related to poor concordance with compression therapy. 12 , 13 , 15 However, difficulties in transitioning from health care dependent, during wound healing, to being able to self‐manage care independently, may also have a significant influence.…”

“…The experience of self‐management has been explored post healing, with evidence that education, patients' knowledge and beliefs around VLUs and compression strongly influence concordance with ongoing prevention activities. 1 , 8 , 9 , 12 , 13 , 15 Evidence also states that without guidance and education patients are not managing this chronic condition. 18 , 19 However, the concept of self‐management, post healing to prevent VLU recurrence, appears to have inconsistencies in terminology, with no clear definitions and possible conflicts in understanding and applications at times.…”

Understanding CEAP Classification: Insights from an Italian Survey on Corona Phlebectatica and Recurrent Active Venous Ulcers by Vascular Specialists

“…VLU affects 1% of the population with a prevalence that increases with age [12]. In the United States, up to 4% of people over the age of 65 are suffering from it [12]. VLUs are usually located on the medial side of the leg and the medial ankle.…”