Oates Angela, Adderley Una
Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, Faculty of Health Sciences, University of Hull, Hull, UK.
School of Healthcare, Faculty of Medicine and Health, The University of Leeds, Leeds, UK.
J Tissue Viability. 2019 May;28(2):115-119. doi: 10.1016/j.jtv.2019.02.004. Epub 2019 Feb 21.
Venous leg ulceration is common in older adults in the United Kingdom. The gold-standard treatment is compression therapy. There are several compression bandage and hosiery systems that can be prescribed or purchased, but it was unclear what types of compression systems are currently being used to treat venous leg ulceration within the UK. This online scoping survey of registered nurses sought to (1) to identify what compression systems are available across the UK, (2) how frequently these are in use and (3) if there are any restrictions on their use.
The results showed that registered nurses who treat patients with venous leg ulceration use a wide range of compression systems. The most frequently used systems are the 'less bulky' two-layer elastic and inelastic compression bandaging systems whilst two-layer hosiery was used less frequently and four-layer bandaging used infrequently. Nurses report that certain compression systems are less accessible through the usual procurement routes but this appears to be related to concerns about competency in application techniques.
The data in this survey provides some important insights into the issues around the use of compression therapy for venous leg ulceration in the UK. Limiting access to certain types of compression may promote patient safety but limit patient choice. There may be underuse of the types of compression that promote patient independence, such as hosiery, and over-use of potentially sub-therapeutic therapy such as 'reduced compression'. Overall, this study suggests that further consideration is needed about the provision of compression therapy to UK patients with venous leg ulceration to optimise care and patient choice.
在英国,老年人中下肢静脉溃疡很常见。金标准治疗方法是压迫疗法。有几种压迫绷带和袜子系统可供处方或购买,但目前尚不清楚在英国用于治疗下肢静脉溃疡的是哪些类型的压迫系统。这项针对注册护士的在线范围界定调查旨在:(1)确定英国各地可用的压迫系统;(2)这些系统的使用频率;(3)其使用是否存在任何限制。
结果显示,治疗下肢静脉溃疡患者的注册护士使用多种压迫系统。最常用的系统是“较轻便”的两层弹性和非弹性压迫绷带系统,而两层袜子的使用频率较低,四层绷带的使用频率更低。护士报告称,某些压迫系统通过常规采购途径较难获得,但这似乎与对应用技术能力的担忧有关。
本次调查的数据为英国下肢静脉溃疡压迫疗法使用方面的问题提供了一些重要见解。限制某些类型压迫的获取可能会提高患者安全性,但会限制患者选择。可能存在促进患者独立性的压迫类型(如袜子)使用不足,以及潜在疗效不足的疗法(如“减压”)使用过度的情况。总体而言,本研究表明,需要进一步考虑为英国下肢静脉溃疡患者提供压迫疗法,以优化护理和患者选择。