Young Katrina, Ng Chok Harrison, Wilkes Lesley
Nepean Hospital, Nepean Blue Mountains Local Health District, Derby Street, Kingswood, NSW 2747 Australia.
Western Sydney University/Nepean Blue Mountains Local Health District, Sydney, Australia.
BMC Nurs. 2017 Sep 21;16:56. doi: 10.1186/s12912-017-0250-2. eCollection 2017.
Intermittent Pneumatic Compression (IPC) is shown to improve the healing rate of Venous Leg Ulcers (VLU) in the hospital setting. The current Australian "Gold Standard" treatment according to the Australian and New Zealand Wound Management Associations' (AWMA) Prevention & Management of Venous Leg Ulcer guidelines is compression, generally in the form of bandaging then progressing to hosiery once wounds are healed to prevent recurrence. This is recommended in conjunction with other standards of wound management including; nutrition, exercise, client education and addressing underlying pathophysiology and psychosocial factors. Compression bandaging is predominantly attended by community nurses in the clients' home. Barriers to delivery of this treatment include; client concordance and or suitability for bandaging including client habitus, (shape of legs), client lifestyle, clinician knowledge and clinicians physical ability to attend bandaging, in particular for obese clients with limited mobility who pose a manual handling risk to the clinician themselves. The use of IPC may assist in mitigating some of these concerns, therefore it would seem wise to explore the use of IPC within the home setting.
This paper will present an original case report on the successful treatment of a woman living with chronic bilateral lower leg ulcers using IPC as an adjunct treatment in her home. This paper supports recommendations to explore the use of IPC therapy in the home setting, for treatment of chronic leg ulcers requiring compression.
Use of IPC in the home is anticipated to improve client involvement, concordance, client outcomes and reduce risk to staff applying conventional compression bandaging systems, particularly for obese clients with limited mobility.
间歇性气动压迫(IPC)已被证明在医院环境中可提高下肢静脉溃疡(VLU)的愈合率。根据澳大利亚和新西兰伤口管理协会(AWMA)的下肢静脉溃疡预防与管理指南,目前澳大利亚的“黄金标准”治疗方法是压迫治疗,通常采用绷带包扎,一旦伤口愈合则改用弹力袜以防止复发。建议将其与其他伤口管理标准结合使用,包括营养、运动、患者教育以及解决潜在的病理生理和社会心理因素。社区护士主要在患者家中进行绷带包扎。这种治疗方法的实施障碍包括:患者的依从性和/或绷带包扎的适用性,包括患者体型(腿部形状)、患者生活方式、临床医生的知识以及临床医生进行绷带包扎的身体能力,特别是对于行动不便的肥胖患者,这对临床医生自身存在手动搬运风险。使用IPC可能有助于减轻其中一些担忧,因此在家庭环境中探索IPC的使用似乎是明智的。
本文将呈现一份原始病例报告,内容是一名患有双侧慢性小腿溃疡的女性在家中使用IPC作为辅助治疗获得成功治疗的案例。本文支持在家庭环境中探索使用IPC疗法来治疗需要压迫治疗的慢性腿部溃疡的建议。
预计在家庭中使用IPC可提高患者的参与度、依从性,改善患者治疗效果,并降低应用传统压迫绷带系统的工作人员所面临的风险,特别是对于行动不便的肥胖患者。