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Advances in Skin & Wound Care:
Features: Original Investigation

Guidelines in Practice: The Effect on Healing of Venous Ulcers

McGuckin, Maryanne Dr ScEd, MT (ASCP); Williams, Liz BA, DN; Brooks, Jill BA (HONS, RGN, DN); Cherry, George PhD

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

DESIGN: Prospective descriptive intervention evaluation.

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

PATIENTS: 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.

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

MAIN OUTCOME MEASURES: Time to healing, compliance with vascular assessment, compression usage, and nursing costs.

MAIN 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 (£170.00 [$250.00] vs £272.00 [$395.00]).

CONCLUSION: 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.

© 2001 Lippincott Williams & Wilkins, Inc.


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