Community clinics for leg ulcers and impact on healing.
BMJ
; 305(6866): 1389-92, 1992 Dec 05.
Article
em En
| MEDLINE
| ID: mdl-1486301
ABSTRACT
OBJECTIVE:
To evaluate the effectiveness of community clinics for leg ulcers.DESIGN:
All patients with leg ulceration were invited to community clinics that offered treatment developed in a hospital research clinic. Patients without serious arterial disease (Doppler ankle/brachial index > 0.8) were treated with a high compression bandage of four layers.SETTING:
Six community clinics held in health centres in Riverside District Health Authority supported by the Charing Cross vascular surgical service. PATIENTS All patients referred to the community services with leg ulceration, irrespective of cause and duration of ulceration. MAIN OUTCOMEMEASURES:
Time to complete healing by the life table method.RESULTS:
550 ulcerated legs were seen in 475 patients of mean (SD) age 73.8 (11.9) years. There were 477 venous ulcers of median size 4.2 cm2 (range 0.1-117 cm2), 128 being larger than 10 cm2. These ulcers had been present for a median of three months (range one week to 63 years) with 150 present for over one year. Four layer bandaging in the community clinics achieved complete healing in 318 (69%) venous ulcers by 12 weeks and 375 (83%) by 24 weeks. There were 56 patients with an ankle/brachial arterial pressure index < 0.8, indicating arterial disease. The 50 patients with pressure index < 0.8 > 0.5 were treated with reduced compression, and 24 (56%) healed by 12 weeks and 31 (75%) by 24 weeks. The figures for overall healing for all leg ulcers were 351/550 (67%) at 12 weeks and 417/550 (81%) at 24 weeks, compared with only 11/51 (22%) at 12 weeks before the community clinics were set up.CONCLUSIONS:
Community clinics for venous ulcers offer an effective means of achieving healing in most patients with leg ulcers.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Úlcera Varicosa
/
Serviços de Saúde Comunitária
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
BMJ
Assunto da revista:
MEDICINA
Ano de publicação:
1992
Tipo de documento:
Article