in the Treatment of Heavily Exudating VLUs Improves Clinical Outcomes and Cost Savings
Introduction: Chronic venous insufficiency is the 7th most common chronic disease and is the underlying cause of 95% of leg ulcers1. Venous leg ulcers (VLUs) are difficult to treat and even with proper care can take a minimum of 12 weeks to heal2. VLUs are a clinical challenge because they are notoriously heavily draining wounds. This drainage contributes to the formation of excessive bioburden, devitalized tissue, and microorganisms, all which prolong wound healing. In order to effectively manage VLU exudate it is not uncommon to change dressings 3 or more times weekly. More frequent dressing changes increase the overall cost of care and may further contribute to delayed wound healing … read more
Objectives The primary objective is to identify instruments used to measure quality of life (QoL) in studies of people with active venous leg ulcers (VLUs). The secondary objective is to map the qualities of each instrument to make recommendations for clinical practice and future research.
Introduction VLUs have a negative impact on patients’ QoL. Prolonged healing and frequent recurrence leads to pain, prolonged disability and psychosocial morbidity. Accurate measurement of QoL can optimise the evaluation of VLU treatments and guide clinician and patient decision-making … read more
A 68-year-old male presented for care with lymphedema and multiple, copiously draining ulcerations on the right lower extremity (Figure 1). Symptoms were present for years and failed to respond to compression, foam dressings, or abdominal pads. Previous medical history included hypertension requiring use of anti-hypertensive medication … read more
Background Adults with venous leg ulcers (VLUs) are less likely to be physically active and show greater sleep disturbances than the general population. Limited evidence suggests these issues contribute to VLU healing delays.
Objectives The primary objective is to determine if physical activity (PA) and sleep levels are associated with VLU healing. The secondary objectives are to: 1) evaluate the feasibility and acceptability of a wrist-worn accelerometer device, wActiSleep-BT device wear (ActiGraph); 2) evaluate the utility of self-reported PA instruments to measure PA for people with VLU; and 3) determine whether PA and sleep levels are associated with i) delayed healing, ii) self-reported quality of life (QoL) and/or iii) self-reported VLU pain … –
Great, provocative work recently in the International Wound Journal by our colleagues Professor Keith Harding and coworkers.1 In their study, they note that healing in total can be a challenging metric to measure, as every wound is very different. In the research world, this translates into difficulty in matching study cohorts, especially when there are not very large subject pools available. Also, they note that the lengthy time necessary to heal many wounds requires that the associated study also takes substantial time. This makes high-quality RCTs with statistically significant and applicable data few and far between.
Taking a slightly different viewpoint on evaluating outcomes in wound healing … read more
Patients who have chronic wounds such as leg ulcers should be active participants in their treatment and care. This participation may include self-treatment of the wound which involves the patient cleaning the wound, applying and removing wound dressings, and/or applying and removing compression therapy. The aim of the study was to develop a Checklist to assist nurses to appraise the conduct of wound treatment when undertaken by the patient. A three-phase mixed methods study was conducted. A systematic and evidence-based approach to developing and using structured observations for the study of health behaviour guided the process of developing, piloting and refining the Checklist … read more
Chronic wounds caused by underlying physiological causes such as diabetic wounds, pressure ulcers, venous leg ulcers and infected wounds affect a significant portion of the population. In order to treat chronic wounds, a strong debridement, removal of necrotic tissue, elimination of infection and stimulation of granulation tissue are required. Maggot debridement therapy (MDT), which is an alternative treatment method based on history, has been used quite widely. MDT is an efficient, simple, cost-effective and reliable biosurgery method using mostly larvae of Lucilia sericata fly species. Larvae can both physically remove necrotic tissue from the wound site and stimulate wound healing by activating molecular processes in the wound area through the enzymes they secrete. The larvae can stimulate wound healing by activating molecular processes in the wound area through enzymes in their excretions/secretions (ES). Studies have shown that ES has antibacterial, antifungal, anti-inflammatory, angiogenic, proliferative, hemostatic and tissue-regenerating effects both in vivo and in vitro. It is suggested that these effects stimulate wound healing and accelerate wound healing … read more