Duke University Medical Center, Raleigh, NC 27606, USA.
J Clin Nurs. 2011 Jan;20(1-2):86-93. doi: 10.1111/j.1365-2702.2010.03431.x. Epub 2010 Nov 17.
This literature review aims to define best nursing practice for lower limb ulcer care promoting stabilisation of this physiological consequence of diabetes mellitus and to help provide improved integration of health-within-illness for the patients.
According to the Centers of Disease Control, the number of people with diabetes has risen from 20·8 million in 2005 to over 23·6 million in 2007. Research has identified best practice algorithms for care of the diabetic foot, yet none for the ulcerations on the limb from the knee to the ankle.
The design of this literature review is to compile research from both nursing and medical communities to develop a best practice for the stabilisation of a lower limb ulcer. A literature search was conducted based on the theoretical framework of stabilisation of a chronic condition.
Twenty-nine articles were identified for use in the evaluation of best practice of lower limb ulcerations. Each article was synthesised using a protocol tool.
Control of hyperglycaemia, infection control, ulcer debridement, use of dressings and compression therapy to relieve venous congestion were all identified as important factors in the treatment of lower limb ulcerations.
This systematic literature review has resulted in a 'best nursing practice algorithm' for the stabilisation and care of lower limb ulcerations regardless of underlying cause. This care algorithm could be used in collaboration with other health care providers to promote stabilisation of lower limb ulcers and improve the overall quality of life of patient cohort.
The results of this study yield a suggested 'best practice' algorithm for the stabilisation of a lower limb ulcer--treat and control hyperglycaemia; prevent and/or control infection of the ulcer; routine debridement of the ulcer; using the most appropriate type of dressings for each patient; and the application of compression therapy. This algorithm can also be used for to frame patient teaching regarding appropriate treatments and therapies to promote the patient's self-care and stabilisation of the ulcer.
本文献综述旨在定义下肢溃疡护理的最佳护理实践，以稳定糖尿病这一生理后果，并帮助为患者提供更好的疾病整体健康护理。
根据疾病控制中心的数据，2005 年患有糖尿病的人数为 2080 万，到 2007 年已上升至 2360 多万。研究已经确定了糖尿病足护理的最佳实践算法，但对于从膝盖到脚踝的肢体溃疡却没有。
本文献综述的设计是将护理和医学两个领域的研究结合起来，为稳定下肢溃疡制定最佳实践。根据稳定慢性病的理论框架进行文献检索。
共确定了 29 篇文章，用于评估下肢溃疡最佳实践。使用协议工具对每篇文章进行综合分析。
控制高血糖、感染控制、溃疡清创、使用敷料和压迫疗法缓解静脉充血，这些都是治疗下肢溃疡的重要因素。
这项系统的文献综述产生了一个“最佳护理实践算法”，用于稳定和护理下肢溃疡，无论其潜在原因如何。该护理算法可以与其他医疗保健提供者合作使用，以促进下肢溃疡的稳定，并提高患者群体的整体生活质量。
本研究结果为稳定下肢溃疡提出了一种建议的“最佳实践”算法——治疗和控制高血糖；预防和/或控制溃疡感染；常规清创溃疡；为每位患者选择最合适的敷料类型；应用压迫疗法。该算法还可用于为患者提供适当治疗和疗法的建议，以促进患者的自我护理和溃疡的稳定。
