Tissue Viability Team, Cambridge University Hospitals NHS Foundation Trust (CUH), Cambridge Biomedical Campus, Hills Road, Cambridge, UK.
University of Hertfordshire, School of Health and Social Work, Department of Nursing, Health and Wellbeing, College Lane, Hatfield, Hertfordshire, UK.
J Wound Care. 2022 Jul 2;31(7):590-597. doi: 10.12968/jowc.2022.31.7.590.
Compression therapy is the mainstay of treatment for venous leg ulceration. Several studies have evaluated leg ulcer management and compression in the community. However, little is known about the leg ulcer population and use of compression therapy in the hospital setting, where it is not often part of inpatient care. This study aimed to evaluate the proportion of inpatients with leg ulceration eligible for compression therapy.
A point prevalence audit was undertaken using three methods: patient electronic live report; a leg ulcer audit form; and an electronic record search. The following data were retrieved: patient age, sex, primary reason for admission, diabetes, mobility status, history of dementia, Clinical Frailty Scale score and presence of oedema. Ankle-brachial pressure index was measured to determine patients' eligibility for compression therapy.
The audit identified 80/931 (8.5%) inpatients as having confirmed, active leg ulceration. A total of 36/80 (45%) inpatients were assessed for eligibility for compression, of whom 25/36 (69.4%) were eligible for full compression, 2/36 (5.6%) reduced compression and 9/36 (25%) were not eligible for compression therapy.
The audit demonstrated that a significant proportion of hospital inpatients with leg ulcers were eligible for compression therapy and that this patient population were heterogenous in terms of comorbidity profile, mobility, frailty and dementia, among other factors. Further research is required to explore the most feasible and effective compression options for inpatients with leg ulcers.
压迫疗法是治疗静脉性腿部溃疡的主要方法。有几项研究评估了社区中腿部溃疡的管理和压迫治疗情况。然而,对于医院环境中腿部溃疡患者人群以及压迫治疗的使用情况,我们知之甚少,因为在医院环境中,压迫治疗通常不是住院治疗的一部分。本研究旨在评估适合压迫治疗的腿部溃疡住院患者的比例。
采用三种方法进行了时点患病率审计:患者电子实时报告、腿部溃疡审计表和电子病历搜索。检索的数据包括:患者年龄、性别、主要入院原因、糖尿病、活动能力状态、痴呆史、临床虚弱量表评分和水肿情况。测量踝肱血压指数以确定患者是否适合压迫治疗。
该审计共发现 931 名住院患者中有 80 名(8.5%)患有确诊的活动性腿部溃疡。对 36 名/80 名(45%)住院患者进行了适合压迫治疗的评估,其中 25/36 名(69.4%)患者适合全压治疗,2/36 名(5.6%)患者适合减压治疗,9/36 名(25%)患者不适合压迫治疗。
该审计表明,相当一部分患有腿部溃疡的住院患者适合压迫治疗,而且这些患者人群在合并症情况、活动能力、虚弱程度和痴呆症等方面存在异质性。需要进一步研究来探讨最适合住院腿部溃疡患者的可行有效的压迫治疗选择。