Improving the treatment of leg ulcers.
Treatment of leg ulcers is often inadequate, with delayed diagnosis, overuse of antibiotics, and insufficient or inadequate use of compression therapy. Ulcers caused by arterial insufficiency will not heal unless the blood flow is improved. Ulcers caused by venous insufficiency will usually heal within a few months with appropriate compression therapy. Compression can be applied with stockings, bandages, or a pump. Class 2 compression stockings are required for treatment of ulcers; TED stockings and Class 1 stockings do not provide adequate compression. A four-layer compression bandage can be used if a patient cannot manage stockings. Applying the bandage with the correct pressure is a skill developed from practice. A pump can be used if neither stockings nor bandages are suitable. However, it must be used for six hours a day, which precludes use by active patients. An ulcer that does not heal with three months of adequate compression therapy requires further investigation.
McMullin
G M
GM
Sutherland Hospital, Sydney, NSW. ssvc@bigpond.com
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001315:Australia / Q000453:epidemiology; D001458:Bandages; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007871:Leg Ulcer / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014945:Wound Healing / Q000502:physiology
D000900:Anti-Bacterial Agents