Related Experiment Videos
Guidelines in practice: the effect on healing of venous ulcers
M McGuckin1, L Williams, J Brooks
1University of Pennsylvania School of Medicine, Philadelphia, USA.
Objective:
To determine the effect of guidelines on vascular assessment, compression usage, dressing selection, and healing rates of patients with a venous ulcer.
Design:
Prospective descriptive intervention evaluation.
Setting:
Oxfordshire Community National Health Service (NHS) Trust, United Kingdom.
Patients:
40 consecutive prospective patients seen by Oxfordshire district nurses, either at home or at a wound clinic coordinated by district nurses located in a surgery office.
Intervention:
The Guideline for Diagnosis and Treatment of Venous Leg Ulcers (University of Pennsylvania) and the Oxfordshire Leg Ulcer Guideline.
Main Outcome Measures:
Time to healing, compliance with vascular assessment, compression usage, and nursing costs.
Main Results:
91% of patients had a vascular assessment; all patients were treated with compression. Mean time to healing was 8 weeks and was not related to dressing selection or type of compression (short- versus long-stretch bandage). Nursing costs were slightly higher for wounds that healed after 12 weeks and were treated with a long-stretch bandage (Pound Sterling 170.00 [$250.00] vs Pound Sterling 272.00 [$395.00]).
Conclusion:
Use of compression was influenced by guidelines that emphasize a vascular assessment. Choice of dressing or type of compression was not a significant factor in healing rates.