Authors (including presenting author) :
Lam WSJ(1), Hgan HL (1)
Affiliation :
Wound & Stoma Care Team, Nursing Services Division, United Christian Hospital
Introduction :
Chronic venous insufficiency is a progressive disease of the circulatory system characterized by venous stasis (prevent backflow of the blood), hypertension, oedema, skin changes and venous ulceration at the lower limbs (VLUs). There are approximately 1% of the general population and 3.5% of people over age 65 have venous ulcers. The number is rising as the population ages. During December 2016-December 2017, there were 566 new cases referred were referred to the GOPC Wound Nurse Clinics of Kowloon East Cluster, and 142 (25%) new cases were related to VLUs. Exercise, leg elevation, structured wound management plus graduated compression therapy has been recommended as the first-line treatment for VLUs. Recently, the nurses in United Kingdom & Australia have used 3 layers of elastic tubular bandage (ETB) as the compression therapy of VLUs. However, the size of the elastic tubular bandage, the pressure provided and the effectiveness are not well documented. Hence, our team has carried out a project to look into this issue.
Objectives :
- To investigate the appropriate size of elastic tubular bandage for different circumference of leg - To investigate the endurance of the elastic tubular bandage
- To evaluate the effectiveness of modified 3 layers elastic tubular bandage
Methodology :
- Patients suffered from venous ulcers and with ABPI >0.8 follow-up in KEC GOPC wound clinic were recruited in the project
- 3 layers modified elastic tubular bandage were offered as the additional wound care treatment. Size of tubular bandage were chosen according to “South West Community Care Access Centre Wound Management Program Measuring Guide”
- Educational leaflet on management of venous insufficient and application of 3 layers elastic tubular bandage were given to patient
- The pressures at lateral malleolus of affected limbs were measured by sub-bandage pressure measuring unit, aim at >18-25mmHg
- The pressure were measured again on week 2and week 4 to ensure sufficient compression are given
- The progress of wound healing and the effectiveness of the modified 3 layers tubular bandage are evaluated after 6 weeks
- All data were charted on a report form
Result & Outcome :
- There are total 11 patients fit the inclusion criteria and were selected in the project. They were advised to put on 3 layers tubular according to the size measured. If approperiate size was choosen, the 3 layes ETB could provide >18-25mmHg at gaiter area which was effective to imporove venous return on lower limbs. The 3- layers ETBS could maintain the pressure up to 4 weeks.
- All patients tolerated the 3-layers ETB compression therapy and improved their quality of life.
- 73% patient’s wounds were healed within 6 weeks, 18% patient’s wound size reduced more than 50% and 9% patient’s wound size remains static. No patient’s wound size became larger nor was any complication noted. Therefore, the ETBs did help in wound healing process.
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