BANDAGING STRATEGY

The Most Effective Bandaging Strategy to Promote Healing In Clients with Chronic Venous Leg Ulcers

The Most Effective Bandaging Strategy to Promote Healing In Clients with Chronic Venous Leg Ulcers

Introduction

Wendy Hayes & Julie Day (2008) in their article "Case studies evaluating 3M's two-layer compression system: Coban 2" explains that venous leg ulcers represent a chronic condition resulting from an incompetent venous system in the legs, which affects capillary pressures and permeability. Conservative treatment generally involves assessment, wound dressing changes, external compression, elevation, and patient education (Hayes & Day, 2008). Due to the underlying pathophysiology, healing of leg ulcers is notoriously slow, with average healing times ranging from 15 to 30 weeks (Hayes & Day, 2008). In this evaluation of a Two-layer compression bandage system, the study of Hayes & Day focuses upon the performance of the bandage together with the patients' perspective regarding comfort and acceptability when carrying out normal daily activities.

Similarly, Elizabeth Mudge, Nicola lvins, Wendy Simmonds and Patricia Price (2007) in their article "Adherence to a 2-layer compression system for chronic venous ulceration" describes that venous leg ulcers demonstrate a 30% to 50% reoccurrence rate (Mudge et al. 2007). The chronicity of the leg ulcer contributes to significant lifestyle change including loss of a job or productive hours, limitations on mobility, and social isolation. Financial expenditures are also considerable with costs in the United States estimated to be $75 million to $1 billion per year (Mudge et al. 2007).

Individuals who experience venous leg ulcers place considerable demands on health services, particularly community-based agencies. Treatment is time consuming and prolonged, requiring health care professionals to focus on the wound or the limb that is affected by the leg ulcer in providing care (Mudge et al. 2007). Although this is essential, current research suggests that a more holistic understanding of the experience of living with a leg ulcer may also be beneficial. Due to the fact that community health nurses are the major care professionals providing care for this challenging health problem, they have considerable opportunity to impact not just wound healing but also the patient's experience of living with a leg ulcer.

Pain, functional limitations, and emotional distress have all been identified as coexisting difficulties associated with living with a leg ulcer. Identification of these symptoms and their effect on lifestyles may provide important information to improve health outcomes, both from a provider and a patient perspective. Goals of alleviating physical and emotional suffering as well as improving wound healing may contribute to decreasing costs associated with leg ulcers.

Venous leg ulcers, like any chronic disease, require self-management on the part of the individual. Self-management, in turn, requires knowledge, functional capabilities, and energy in order to support healing behaviors. This preliminary research study sought to determine if individuals with venous leg ulcers had the necessary knowledge to participate in self-management and whether they were capable of performing the self-management skills that would enhance healing.

Mudge et al. (2007) reported that individuals with leg ulcers experienced significantly greater pain, mobility problems, ...