Ehmann S, Whitaker J C, Hampton S, Collarte A
Clinical Specialist, Carolinas HealthCare System Stanly.
Director and Nurse Consultant, Senior Lecturer - University of Central Lancashire, Northern Lymphology Ltd.
J Wound Care. 2016 Sep;25(9):513-20. doi: 10.12968/jowc.2016.25.9.513.
The aim of this small pilot audit was to record the performance of an adjustable Velcro compression wrap, ReadyWrap, and the experiences of patients and health-care professionals using the system as a self-care option for the management of venous and lymphatic leg conditions in both the treatment and maintenance phases.
This audit was held within a 4-week review period. Participants included venous leg ulcer (VLU) patients with and without oedema, and patients with lymphoedema. Where open wounds were present they were managed with debridement, skin care and dressings according to clinical need. Lymphoedema patients received manual lymphatic drainage and skin care regimens as per standard practice. The Velcro system evaluated formed part of a treatment pathway with compression bandages and/or compression hosiery as clinically indicated. Patients, carers and health-care professionals applied the garments following assessment and training. Objective data recorded included change in circumferential measurements and improvement in wound status. Observation of health-care professionals, patients and carers with regard to the comfort and ease of application/removal of the device were recorded.
There were 17 patients included in the audit. Within the 4-week period a reduction in limb circumference was recorded in all cases. Improvements in open wounds were recorded in most cases. Following the 4-week audit period 94% of the application of the device was performed by either the patient (59%) or the carer (35%) thereby reducing the health-care professional contact that was required for application.
Early results in this small audit demonstrate that this adjustable Velcro compression wrap may provide a simple, clinically effective and patient-acceptable solution for self-care with compression. Use of this type of device could have the potential to reduce overall health-care burden by reducing necessary skilled treatment visits and/or cost while still achieving good clinical outcomes. Further studies are required to confirm this pilot study and provide additional data.
这项小型试点审核的目的是记录一种可调节的尼龙搭扣加压绷带(ReadyWrap)的性能,以及患者和医护人员使用该系统作为治疗和维持阶段下肢静脉和淋巴疾病自我护理选项的体验。
本次审核在为期4周的复查期内进行。参与者包括有或没有水肿的下肢静脉溃疡(VLU)患者以及淋巴水肿患者。对于存在开放性伤口的情况,根据临床需要进行清创、皮肤护理和包扎。淋巴水肿患者按照标准做法接受手动淋巴引流和皮肤护理方案。所评估的尼龙搭扣系统作为治疗途径的一部分,根据临床指征与加压绷带和/或加压袜配合使用。患者、护理人员和医护人员在接受评估和培训后使用这些衣物。记录的客观数据包括周长变化和伤口状况的改善情况。记录医护人员、患者和护理人员对该装置应用/移除的舒适度和难易程度的观察结果。
审核纳入了17名患者。在4周内,所有病例的肢体周长均有减小。大多数病例的开放性伤口有所改善。在为期4周的审核期后,该装置94%的应用由患者(59%)或护理人员(35%)完成,从而减少了应用时所需的医护人员接触。
这项小型审核的早期结果表明,这种可调节的尼龙搭扣加压绷带可能为加压自我护理提供一种简单、临床有效的且患者可接受的解决方案。使用这类装置有可能通过减少必要的专业治疗就诊次数和/或成本,同时仍能取得良好的临床效果,从而减轻总体医疗负担。需要进一步研究来证实这项试点研究并提供更多数据。