Moffatt C J, O'Hare L
Ostomy Wound Manage. 1995 May;41(4):16-8, 20, 22-5.
Venous leg ulceration is a major tissue viability problem that is becoming better recognized as clinical wound care practice changes from being anecdotal-based to research-based. The current prevalence of leg ulceration in the UK, Sweden and Australia is approximately 1 percent of the adult population, and approximately half a million in the United States. Between 70 and 90 percent of leg ulcers in the UK are venous in origin. Research has shown that graduated compression bandaging is an appropriate method of managing venous leg ulceration for many patients. Since Stemmer's work showing the usefulness of higher levels of external pressure (40 mmHg), the reliability and predictability of the four layer high compression bandaging system has been demonstrated. The purpose of this article is to introduce the extent of the venous leg ulceration problem, discuss risk factors and other aspects of venous leg ulceration, support the use of graduated compression, and describe the four layer high compression bandage system. The success of the four layer system is linked to the wider issues of using a research-based approach to the assessment and management of venous leg ulcers, and such an approach is integral to cost-effective, high quality patient care.
下肢静脉性溃疡是一个严重的组织存活问题。随着临床伤口护理实践从基于经验转向基于研究，这一问题正得到越来越多的认识。在英国、瑞典和澳大利亚，目前下肢溃疡的患病率约为成年人口的1%，在美国约有50万例。在英国，70%至90%的下肢溃疡源于静脉。研究表明，对于许多患者而言，压力梯度弹力袜包扎是治疗下肢静脉性溃疡的一种合适方法。自从施特默的研究表明较高水平的外部压力（40 mmHg）有用以来，四层高压力包扎系统的可靠性和可预测性已得到证实。本文的目的是介绍下肢静脉性溃疡问题的严重程度，讨论静脉性溃疡的危险因素及其他方面，支持使用压力梯度弹力袜包扎，并描述四层高压力绷带系统。四层系统的成功与采用基于研究的方法评估和管理下肢静脉性溃疡这一更广泛的问题相关联，而这种方法对于具有成本效益的高质量患者护理至关重要。
