Simon D A, McCollum C N
Ostomy Wound Manage. 1996 Mar;42(2):34-8, 40.
The traditional approach to leg ulcer care is both expensive and achieves poor outcomes. The outcome of treatment for patients with venous ulceration has been improved using a more scientific and research-based approach to patient assessment, adequate compression bandaging, use of other procedures such as pinch skin grafting and simple venous surgery, and the delivery of these innovations in patient care to the community as a whole. Multi-layer compression bandaging is superior to standard (one-layer) bandaging because it can easily be adapted to a wide range of ankle circumferences and leg sizes to provide sustained, graduated compression. Pinch skin grafting is cost-effective, accelerates healing, and, following adequate training, may be performed by specialist nurses in the community. Simple venous surgery may be offered under local anaesthesia when only the superficial veins are incompetent; however, deep venous surgery has yet to prove itself in clinical practice. Implementation of dedicated community leg ulcer clinics using these research-based findings will result in a substantially reduced prevalence of venous leg ulceration.
传统的腿部溃疡护理方法既昂贵又效果不佳。采用更科学、基于研究的患者评估方法、适当的加压包扎、使用其他手术（如点状植皮和简单的静脉手术），并将这些患者护理方面的创新推广到整个社区，已改善了静脉性溃疡患者的治疗效果。多层加压包扎优于标准（单层）包扎，因为它可以轻松适应各种脚踝周长和腿部尺寸，以提供持续的、分级的压力。点状植皮具有成本效益，可加速愈合，经过充分培训后，社区的专科护士即可进行。当只有浅静脉功能不全时，可在局部麻醉下进行简单的静脉手术；然而，深静脉手术在临床实践中尚未得到验证。利用这些基于研究的结果设立专门的社区腿部溃疡诊所，将大幅降低静脉性腿部溃疡的患病率。
