Chronic leg ulcers in Sweden: a survey of wound management

The aim of this study was to survey management of leg ulcers by staff in Swedish primary healthcare (PHC) and home care services (HCS) run by the municipalities (n = 933), with emphasis on wound care and education. A questionnaire was completed by 933 staff (78% response rate). Diagnostic investigation and documentation in specific wound records was performed by 46.6% of respondents in PHC and 12.8% in HCS, most commonly by nurses in PHC compared to nurse auxiliaries (NAs) in the HCS. Topical treatment was most commonly chosen by nurses (82.1%). Nurse auxiliaries in PHC had greatest access to structured wound management programmes (40.0% compared with 30.1% in HCS, p < 0.05). Instruction courses, mainly organised by pharmaceutical companies (43.2%), were the most common form of education (20.4%) identified. The most time-consuming wound dressings and the highest number of patients treated at home and by NAs were found in the municipalities. For topical treatment 29 products were identified. Nurses in both PHC and the HCS used a wider range of products, e.g. hydrocolloids and absorptive dressings, than NAs in nursing homes, who used dry gauze/protective dressings and wet saline gauze to a greater extent. Substantial differences in qualifications, wound management experience and resource utilisation were found between staff in PHC and the HCS.