Anderson Irene
Principal Lecturer, Tissue Viability, Reader in Learning and Teaching, University of Herfordshire, Hatfield.
Br J Nurs. 2017 Jun 22;26(12 Suppl):S32-S41. doi: 10.12968/bjon.2017.26.12.S32.
Leg ulcers present with a variety of aetiologies, sometimes in combination. The most common aetiology is venous, with treament involving compression, elevation and exercise; the most common treatment setting is the community. However, people with leg ulcers do sometimes require admission to hospital for conditions and situations which may, or may not, be ulcer-related. There is a lack of contemporary evidence on the experience of inpatients and insufficient analysis of the impact on healing and complications to the lower limb when patients with leg ulcers and compression therapy are admitted to hospital. Admission to hospital presents an ideal opportunity for a focus on leg care and potentially enhancing healing rates of patients. The reality for patients with venous leg ulceration being treated with compression therapy is that this does not continue if they are admitted to hospital as inpatients-having been interrupted for MRSA screening and skin assessment, often no-one is available to reinstate the therapy. This article highlights key issues in the ongoing care of these patients and offers suggestions for basic management until a more acceptable and evidence-based solution can be found. Part 2 will deal with the preparation for discharge and options for the treatment of patients who are not already in the care of community services.
腿部溃疡有多种病因，有时是多种病因共同作用。最常见的病因是静脉性的，治疗方法包括加压、抬高和运动；最常见的治疗场所是社区。然而，腿部溃疡患者有时确实需要因可能与溃疡相关或可能无关的情况而住院。目前缺乏关于住院患者经历的当代证据，并且对腿部溃疡患者和接受加压治疗的患者住院时对下肢愈合和并发症的影响分析不足。住院提供了一个关注腿部护理并可能提高患者愈合率的理想机会。接受加压治疗的下肢静脉溃疡患者的实际情况是，如果他们作为住院患者入院，这种治疗就会中断——因为要进行耐甲氧西林金黄色葡萄球菌（MRSA）筛查和皮肤评估，而且通常没有人能恢复这种治疗。本文强调了这些患者持续护理中的关键问题，并提供了基本管理建议，直到找到更可接受且基于证据的解决方案。第二部分将讨论出院准备以及尚未接受社区服务护理的患者的治疗选择。
