Guidelines in practice: the effect on healing of venous ulcers.
OBJECTIVE
To determine the effect of guidelines on vascular assessment, compression usage, dressing selection, and healing rates of patients with a venous ulcer.


METHODS
Prospective descriptive intervention evaluation.


METHODS
Oxfordshire Community National Health Service (NHS) Trust, United Kingdom.


METHODS
40 consecutive prospective patients seen by Oxfordshire district nurses, either at home or at a wound clinic coordinated by district nurses located in a surgery office.


METHODS
The Guideline for Diagnosis and Treatment of Venous Leg Ulcers (University of Pennsylvania) and the Oxfordshire Leg Ulcer Guideline.


METHODS
Time to healing, compliance with vascular assessment, compression usage, and nursing costs.


RESULTS
91% of patients had a vascular assessment; all patients were treated with compression. Mean time to healing was 8 weeks and was not related to dressing selection or type of compression (short- versus long-stretch bandage). Nursing costs were slightly higher for wounds that healed after 12 weeks and were treated with a long-stretch bandage (Pound Sterling 170.00 [$250.00] vs Pound Sterling 272.00 [$395.00]).


CONCLUSIONS
Use of compression was influenced by guidelines that emphasize a vascular assessment. Choice of dressing or type of compression was not a significant factor in healing rates.
McGuckin
M
M
University of Pennsylvania School of Medicine, Philadelphia, USA.
Williams
L
L
Brooks
J
J
Cherry
G
G
D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D011312:Pressure; D011446:Prospective Studies; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000473:pathology / Q000628:therapy*; D014945:Wound Healing