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Clinical Research
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Getting a leg upÑprevalence, comorbidities, treatment, and outcomes of leg and foot ulcers in an outpatient wound care clinic Julie Anderson, PhD, RN, CCRC, Patricia Thompson, MS, RN, Susan Hunter, MSN, RN, Darlene Hanson, MS, RN, Diane Langemo, PhD, RN, Dan Rustvang, FNP, Rolf Paulson, MD. Statement of the Problem: Leg and foot ulcers are a common, costly, and morbid condition. The cost of ulcer management in dollars, time, and effort, is substantial. Despite treatment, ulcers frequently become chronic Methodology: Retrospective chart review of clients from a Midwestern rural outpatient wound care clinic. Research questions include:..1.What types of lower extremity ulcers are seen in a rural outpatient wound clinic population?.2.What risk factors and coexisting medical conditions are associated with different types of lower extremity ulcers? .3.What are the differences in healing time and recurrence rates for lower extremity ulcers based on etiology, location, type of treatment, and other clinical factors?..Results: This study provides descriptive and correlational data on 114 lower extremity ulcer clients (51.8% women and 48.2% men) treated at an outpatient wound care clinic. The mean client age was 70.6 years and the average weight 204.9 pounds. The most prevalent comorbidities included hypertension (81.8%), peripheral vascular disease (73.7%), and coronary artery disease (50.0%). The most frequent ulcer etiologies were venous (35.1%), diabetic (24.6%), and pressure (14.8%), which occurred most commonly on the lower leg (25.4%), ankle (25.4%), or foot (15.8%). Fifty-nine percent of ulcers healed with an average healing time of 116.5 days. Silver impregnated dressing was the most common treatment used (65.8%) and four-layer wrap the most frequent form of compression therapy (35.1%). Conclusion: Frequent assessment and modification of treatment modalities positively impacted wound healing of clients with lower extremity ulcers. . Baranoski S, Ayello EA. Wound Care Essentials: Practice Principles. Philadelphia, Pa: Lippincott Williams & Wilkins, 2003 Harrison MB, Graham ID, Friedberg E, Lorimar K, Vandevelde-Coke S. Regional planning study. Assessing the population with leg and foot ulcer. Canadian Nurs. 2001;97(2):18Ð23. Mekkes JR, Loots MA, Van Der Wal AC, Bos JD. Causes, investigation and treatment of leg ulceration. Br J Dermatol. 2003;148(3):388Ð401 Sieggreen MY, Kline RA. Recognizing and managing venous leg ulcers. Adv Skin Wound Care. 2004;17(6):302Ð313 Wipke-Tevis DD, Rantz MJ, Mehr DR, et al. Prevalence, incidence, management, and predictors of venous ulcers in the long-term-care population using MDS. Adv Skin Wound Care. 2000;13(5):218Ð226 . |
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